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Transcatheter Leadless Pacemakers Feasible for Implantation in Children

Among 62 patients with successful implantation, 10 complications occurred, but there were no deaths, TLP infections, or device embolizations

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 12, 2023 (HealthDay News) — Transcatheter leadless pacemakers (TLP) can be successfully implanted in pediatric patients, according to a study published online April 11 in Circulation: Arrhythmia and Electrophysiology.

Maully Shah, M.B.B.S., from the Children’s Hospital of Philadelphia, and colleagues examined clinical indications, procedural characteristics, electrical performance, and outcomes of TLP implantation in children using retrospective data collected from patients enrolled in the Pediatric and Congenital Electrophysiology Society TLP Registry. A total of 63 registry patients aged 21 years and younger who underwent Micra TLP implantation were included in the study.

A device was successfully implanted in 62 patients at a mean age of 15 ± 4.1 years, including 20 patients with congenital heart disease. The researchers found that TLP was implanted by femoral and internal jugular venous approaches (55 and eight patients, respectively). There were 10 (16 percent) complications reported during a mean follow-up of 9.5 ± 5.3 months, including one cardiac perforation/pericardial effusion, one nonocclusive femoral venous thrombus, and one retrieval and replacement of TLP due to high thresholds. No deaths, TLP infections, or device embolizations occurred. Electrical parameters remained stable and included capture thresholds, R wave sensing, and pacing impedances.

“The leadless pacemaker works very well in children, just like it does in adults. We found it may be safely implanted in select pediatric patients that need pacing,” Shah said in a statement. “Our study’s results indicate select children may be considered candidates since they may benefit greatly from leadless pacing.”

One author disclosed financial ties to Medtronic, the manufacturer of the leadless pacemaker used in the study.

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