LEADLESS PACING VS TVP: ASSOCIATIONS WITH TRICUSPID REGURGITATION AND CARDIOMYOPATHY

Document Type

Conference Proceeding

Publication Date

4-1-2024

Publication Title

J Am Coll Cardiol

Abstract

Background Prior reports suggest leadless pacing (LP) is associated with less de novo cardiomyopathy compared to transvenous pacing (TVP). However, the effect of LP vs TVP on progression of cardiomyopathy (CM) and tricuspid regurgitation (TR) is less clear. Methods We extracted clinical data from adults receiving LP or TVP from 2016-2022 at a large tertiary-care system. Adjusted differences were analyzed between groups for a composite outcome of mortality and heart failure (HF) hospitalization using Kaplan-Meier (KM) analysis. After propensity score matching LP and TVP recipients with 12 variables (fig. 1B), we used Wilcoxon signed-rank tests to evaluate baseline and post-implant (LVEF, new CM, need for biventricular pacing, and TR grade) differences. Results Of 4985 patients, 108 had LP and 4877 TVP with median follow-up 3.1 years (IQR 1.6-5.1). KM analysis showed no significant differences in the composite outcome between groups (fig. 1A). There were no differences in baseline metrics after matching (fig. 1B). Post-implant CM and TR outcomes in the matched subset also showed no significant differences (fig. 1C). Conclusion LP compared to TVP was not associated with improved cardiomyopathy outcomes; this finding differs from prior reports. There was also no significant difference between groups in TR progression. Replication of these results in a large cohort may suggest more limited benefits of LP than previously reported, which can better inform patient selection and counseling. [Formula presented]

Volume

83

Issue

13

First Page

193

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