Abstract 15956: Leadless Cardiac Pacemaker: Does Anatomical Position at Implant Affect Long Term Electrical Performance?
Introduction: Nanostim™ Leadless Cardiac Pacemakers (LCPs) have been shown to be safe and efficacious in human clinical trials. Although the recommended position of the LCP by the manufacturer (St. Jude Medical) is the apical septum, pacing characteristics of the LCP in various cardiac positions is unknown.
Hypothesis: determine whether anatomic position affects long term pacing threshold and sensing amplitudes
Methods: 674 patients were analyzed with LCP’s implanted in various cardiac positions. Data were at the time of implant, 2 weeks, 6 weeks, and 6 months post implant. The final implant position as determined by the implanting investigators, was categorized as RV apical septum (RVAS, n= 198), RV apex (RVA, n=232) and Septum (RVS, n= 244).
Results: At implant, mean pacing capture thresholds in the RVAS, RVA and RVS were 0.77 ±0.44, 0.80 ±0.6 and 0.78 ±0.59, respectively. Sensing amplitudes were 8.0 ±1.9 mV 7.5 ±1.5mV and 7.5 ±1.8mV, respectively. There was no difference between the groups in pacing thresholds, sensing amplitudes and impedances over the 6 months of follow up (p=0.58).While pacing thresholds (Figure-1) and impedances in all 3 cardiac positions did not change (p=0.74) R wave amplitudes (mV) in all implant position groups increased significantly over time (P=0.001).
Conclusions: LCP implant location does not affect pacing thresholds, impedances or sensing amplitudes at 6 months. While implant location does not appear to be a predictor of electrical performance, additional long-term data will help guide optimal implant location.
Author Disclosures: J. Ip: None. A. safadi: None. R. Banker: None. D. Exner: Research Grant; Significant; Medtronic Inc., St. Jude, Boston Scientific, HeartForce Medical, GE Healthcare. Ownership Interest; Modest; Analytics 4Life. Consultant/Advisory Board; Modest; Medtronic Inc, HeartForce Medical. S. Dukkipati: Research Grant; Significant; biosense webster. M. Rashtian: None. I. Niazi: None.
- © 2016 by American Heart Association, Inc.