Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa.
Monaldi Arch Chest Dis. 2020 Nov 20;90(4). doi: 10.4081/monaldi.2020.1255.
Rates of cardiac pacemaker implantation rise with age, and, meanwhile, elderly patient may be at great risk of complications, as pneumothorax, lead perforation, or pocket dehiscence. The use of leadless pacemaker could overcome peri- and post-procedural complications related to the presence of transvenous leads and pocket. The study aims to investigate feasibility and outcomes of Micra Transcatheter Pacing System (M-TPS) implantation in elderly, which represents a challenge for conventional cardiac pacing. Between May 2014 and July 2019, 109 patients (88 males, mean age 77.71±9.68 years) underwent M-TPS implantation at our Center, targeting a non-apical site of delivery when feasible. Study population was divided into two groups according to age (group 1 <79 years vs group 2 group 2 ≥80 years). The outcome evaluation included electrical performance at hospital discharge, and during follow-up. In 46/109 cases (34 males, 73.91%) M-TPS was implanted in patients older than 80 years. There were no statistically significant differences between groups for demographics characteristics, except for age. The procedure was performed via the right femoral access in 102/109 cases and was successful in all cases, with no device-related events. No differences were observed between groups in procedure duration, single device delivery, electrical performance at implant and at 12 month F-U. MTP-S implant is an effective and safe procedure in elderly patients, with similar electrical performance and outcome compared with younger patients at mid-term follow-up.
心脏起搏器植入率随年龄增长而上升，而老年患者可能面临气胸、导线穿孔或囊袋裂开等并发症的高风险。无导线起搏器的使用可以克服与经静脉导线和囊袋相关的围手术期和术后并发症。本研究旨在探讨 Micra 经导管起搏系统（M-TPS）在老年患者中的植入的可行性和结果，这对传统心脏起搏是一个挑战。2014 年 5 月至 2019 年 7 月，我们中心对 109 例患者（88 例男性，平均年龄 77.71±9.68 岁）进行了 M-TPS 植入，当可行时，目标是将输送部位放置于非心尖部位。根据年龄将研究人群分为两组（组 1 <79 岁，组 2 ≥80 岁）。出院时和随访期间评估电性能。在 109 例患者中，46 例（34 例男性，73.91%）年龄大于 80 岁。除年龄外，两组在人口统计学特征方面无统计学差异。102/109 例患者经右股动脉入路进行手术，所有患者均成功植入，无器械相关事件。两组在手术时间、单个器械输送、植入时和 12 个月随访时的电性能方面无差异。在中期随访中，与年轻患者相比，MTP-S 植入在老年患者中是一种有效且安全的方法，电性能和结果相似。
