Pediatric/Adult Congenital Heart Disease -> Pediatric Cardiology D-MP08 - Pediatric and Arrhythmia & Device Management (ID 12) Moderated ePoster

D-MP08-04 - Transcatheter Leadless Pacemaker Implantation In Pediatric Patients: A Multi-center Study In The Real World Setting (ID 1477)


Background: The Micra transcatheter leadless pacing system (TPS) is designed to limit pocket and lead related complications. TPS may be an alternative pacing method in selected children but its efficacy and safety have not been studied in this population.
Objective: We sought to describe indications, electrical performance and outcomes of TPS in children.
Methods: A multi-center retrospective study was conducted with inclusion criteria of age at implant < 21 years and follow up >3 months. Primary end points were stability of pacing threshold and freedom from major complications at 3 months after TPS implant.
Results: Eighteen patients (9 females) met study inclusion criteria and follow up was 11±4 months. Patient, electrical and procedure characteristics are shown in Table 1. Indications for pacing were AV block in 14(77%) and sinus pauses in 4(22%). TPS was delivered via right femoral vein (FV) in 16(88%), left FV in 1(4%) and left internal jugular vein in 1(4%). Micra was fixed to mid-septum in 6(33%), high septum in 3(16%), apical septum in 6(33%) and apex in 3(16%). There were no significant differences in electrical parameters at implant and at 3 months post-implant. There were 15(83%) patients with pacing thresholds < 1V at 0.24ms pulse width. One (5%) implant related complication occurred in the youngest patient (age 7 years) who developed a pericardial effusion.
Conclusion: In this pediatric cohort, the Micra TPS achieved 95% freedom from major complications and delivered stable electrical performance at short term follow up. A prospective registry is needed to evaluate patient selection and long term performance and safety of Micra TPS in the pediatric population.