Outcomes of leadless pacemaker implantation in patients with mechanical heart valves

Autor:	Gerard Loughlin, Marta Pachón, José Luis Martínez‐Sande, José Luis Ibáñez, Teresa Bastante, Joaquín Osca Asensi, Laila González Melchor, Juan Gabriel Martínez‐Martínez, Javier Cuesta, Miguel A. Arias
Rok vydání:	2022
Předmět:	Pacemaker Artificial Heparin cardiac pacing mechanical heart valve prosthesis Heart Valves infection Leadless pacemaker anticoagulation cardiac pacing endocarditis infection mechanical heart valve prosthesis Treatment Outcome Physiology (medical) Heart Valve Prosthesis endocarditis Humans Leadless pacemaker anticoagulation Cardiology and Cardiovascular Medicine Retrospective Studies
Zdroj:	JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
ISSN:	1540-8167 1045-3873
Popis:	INTRODUCTION: Device infections constitute a major complication of transvenous pacemakers. Mechanical heart valves (MHV) increase the risk of infective endocarditis (IE) and pacemaker infection, requiring lifelong vitamin K-antagonists (VKA), which may affect patient management. Leadless pacemakers (LP) are associated with low infection rates, posing an attractive option in MHV patients requiring permanent pacing.This study describes outcomes following LP implantation in patients with MHV. METHODS: This is a multicenter, observational, retrospective study including consecutive patients implanted with an LP at 5 centers between June 2015 and January 2020.Procedural outcomes, antithrombotic management, complications, performance during follow-up and episodes of bacteremia and IE were compared between patients with and without an MHV (MHV and non-MHV groups). RESULTS: Four hundred fifty-nine patients were included (74 in the MHV group, 16.1%, and 385 in the non-MHV group, 83.9%).Procedural outcomes and acute electrical performance were comparable between groups.Vascular complications and cardiac perforation occurred in 2.7 vs. 2.3% (p=1) and 0% vs. 0.8% (p=1) in the MHV group and non-MHV group.One case of IE occurred in the MHV group and 2 in the non-MHV group.In MHV patients, uninterrupted VKA was used in 83.8 %, whereas 16.2 % were heparin-bridged.Vascular complication or tamponade occurred in 1(8.3 %) MHV heparin-bridged patient vs. 1 (1.6 %) MHV uninterrupted VKA patient (p=0.3). CONCLUSION: LP implantation outcomes in MHV patients are comparable to the general LP population.Device-related infections are rare following LP implantation, including in patients with MHV.In the MHV group, periprocedural anticoagulation management was not associated with significantly different rates of tamponade or vascular complication. This article is protected by copyright. All rights reserved.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6176ddc286f8af45a696479223a9b35b https://pubmed.ncbi.nlm.nih.gov/35322490 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.