Shantha Ghanshyam, Brock Jonathan, Singleton Matthew J, Schmitt Alexander Joseph, Kozak Patrick, Bodziock George, Bradford Natalie, Whalen Patrick, Bhave Prashant
Cardiac Electrophysiology, Wake Forest University, Winston-Salem, North Carolina, USA.
Wellspan Hospital, York, Pennsylvania, USA.
J Cardiovasc Electrophysiol. 2023 Sep;34(9):1896-1903. doi: 10.1111/jce.16019. Epub 2023 Jul 31.
AVEIR-VR leadless pacemaker (LP) was recently approved for clinical use. Although trial data were promising, post-approval real world data with regard to its effectiveness and safety is lacking. To report our early experience with AVEIR-VR LP with regard to its effectiveness and safety and compare it with MICRA-VR.
The first 25 patients to undergo AVEIR-VR implant at our institution between June and November 2022, were compared to 25 age- and sex-matched patients who received MICRA-VR implants.
In both groups, mean age was 73 years and 48% were women. LP implant was successful in 100% of patients in both groups. Single attempt deployment was achieved in 80% of AVEIR-VR and 60% of MICRA-VR recipients (p = 0.07). Fluoroscopy, implant, and procedure times were numerically longer in the AVEIR-VR group compared to MICRA-VR group (p > 0.05). No significant periprocedural complications were noted in both groups. Incidence of ventricular arrhythmias were higher in the AVEIR-VR group (20%) compared to the MICRA-VR group (0%) (p = 0.043). At 2 and 8 weeks follow-up, device parameters remained stable in both groups with no device dislodgements. The estimated battery life at 8 weeks was significantly longer in the AVEIR-VR group (15 years) compared to the MICRA-VR group (8 years) (p = 0.047). With 3-4 AVEIR-VR implants, the learning curve for successful implantation reached a steady state.
Our initial experience with AVEIR-VR show that it has comparable effectiveness and safety to MICRA-VR. Larger sample studies are needed to confirm our findings.
AVEIR-VR无导线起搏器(LP)最近被批准用于临床。尽管试验数据很有前景,但关于其有效性和安全性的批准后真实世界数据尚缺。报告我们在AVEIR-VR LP有效性和安全性方面的早期经验,并将其与MICRA-VR进行比较。
将2022年6月至11月在我们机构接受AVEIR-VR植入的前25例患者与25例年龄和性别匹配的接受MICRA-VR植入的患者进行比较。
两组的平均年龄均为73岁,48%为女性。两组100%的患者LP植入成功。80%的AVEIR-VR接受者和60%的MICRA-VR接受者实现了单次尝试植入(p = 0.07)。与MICRA-VR组相比,AVEIR-VR组的透视、植入和手术时间在数值上更长(p > 0.05)。两组均未发现明显的围手术期并发症。AVEIR-VR组的室性心律失常发生率(20%)高于MICRA-VR组(0%)(p = 0.043)。在2周和8周随访时,两组的设备参数均保持稳定,无设备移位。与MICRA-VR组(8年)相比,AVEIR-VR组在8周时的估计电池寿命明显更长(15年)(p = 0.047)。植入3-4个AVEIR-VR后,成功植入的学习曲线达到稳定状态。
我们在AVEIR-VR方面的初步经验表明,它在有效性和安全性方面与MICRA-VR相当。需要更大规模的样本研究来证实我们的发现。