Toon Lin-Thiri, ElRefai Mohammed, Abouelasaad Mohamed, Patil Roopa, Paisey John, Yue Arthur, Roberts Paul
Cardiac Rhythm Management Research Department, University Hospital Southampton, Southampton, SO16 6YD, UK.
University of Southampton, Southampton, UK.
J Interv Card Electrophysiol. 2025 Jan;68(1):117-123. doi: 10.1007/s10840-024-01907-7. Epub 2024 Aug 19.
MICRA implantation is not commonly done as a day-case procedure. Elective leadless pacemakers are implanted routinely in our centre.
To assess whether the day-case MICRA procedure is safe.
We retrospectively collected data from all patients undergoing elective MICRA implantation at our centre between May 2014 and Nov 2022 (n = 81). Two patient groups were stratified: those planned to be discharged on the same day (SD, n = 52) and those planned to be observed overnight after the procedure (ON, n = 29). Patient demographics, size of the sheath used, type of MICRA device, and rate of complications were recorded. In patients with successful implants (n = 80), device function at discharge and first routine follow-up were evaluated.
There were 58% males in the SD group and 45% in the ON group. Median age was 49 years in the SD and 67 years in the ON. Among patients who were planned as a day case, 8 patients had to stay in the hospital but for < 48 h: 2 due to minor groin bleeding, 1 due to patient's request despite fit to discharge, 4 due to the procedure carried out later in the day, and 1 for observation due to procedural complexity. MICRA implantation was successful in 80 patients. The rate of the major complications was 2% in the SD group and 7% in the ON group (p = 0.223), and none of the co-morbidities assessed showed an association with any complications. Device parameters at the follow-up were available in 76 patients. The rate of patients with low and stable PCT at follow-up was also 98% in the SD group and 96% in the ON group.
Day case MICRA procedure can be performed safely in an appropriately selected patient population.
Micra植入术通常不作为日间手术进行。在我们中心，择期无导线起搏器植入术是常规操作。
评估日间Micra手术是否安全。
我们回顾性收集了2014年5月至2022年11月期间在我们中心接受择期Micra植入术的所有患者的数据（n = 81）。将患者分为两组：计划当日出院的患者（SD组，n = 52）和计划术后过夜观察的患者（ON组，n = 29）。记录患者的人口统计学资料、所用鞘管的尺寸、Micra装置的类型以及并发症发生率。在植入成功的患者（n = 80）中，评估出院时和首次常规随访时的装置功能。
SD组男性占58%，ON组男性占45%。SD组的中位年龄为49岁，ON组为67岁。在计划作为日间手术的患者中，有8名患者不得不留院，但住院时间<48小时：2名患者因腹股沟轻微出血，1名患者因尽管符合出院条件但患者要求留院，4名患者因手术在当天较晚进行，1名患者因手术复杂需要观察。80例患者Micra植入成功。SD组的主要并发症发生率为2%，ON组为7%（p = 0.223），所评估的合并症均与任何并发症无关联。76例患者有随访时的装置参数。随访时PCT低且稳定的患者比例在SD组为98%，在ON组为96%。
在经过适当选择的患者群体中，日间Micra手术可以安全进行。
