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one-year outcomes of the first 1000 patients implanted with th micra AV leadless pacing system in france: the AV-CESAR cohort study

Title: one-year outcomes of the first 1000 patients implanted with th micra AV leadless pacing system in france: the AV-CESAR cohort study
Authors: Kerkouri, F; Clementy, N; Defaye, P; Anselme, F; Badoz, M; Behar, N; Bordachar, P; Deharo, J C; Garcia, R; Guenancia, C; Jacon, P; Ollitrault, P; Boveda, S; Mansourati, J; Marijon, E
Source: Europace ; volume 27, issue Supplement_1 ; ISSN 1099-5129 1532-2092
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Background Evidence supporting the Medtronic Micra AV leadless pacing system has largely come from industry-sponsored studies and highly experienced centers, which may introduce bias into its overall evaluation. Purpose The AV-CESAR study aimed to evaluate the Micra AV leadless pacing system in a nationwide, real-world cohort in France. Methods This retrospective study enrolled the first 1000 patients implanted with a Medtronic Micra AV leadless pacemaker in France between 2020 and 2024. The mean follow-up duration was 13.4±10.6 months. The primary endpoints were early (in-hospital) and late (post-discharge) device-related major complications, focusing on pacemaker syndrome and device revision (need for a new pacing system). Results Out of 1003 patients, the device was successfully implanted in 1000 (99.7%). Mean age was 72.0±15 years, 62.8% male, 44.0% with ≥2 comorbidities, and 51.0% were considered unsuitable for transvenous pacemaker. The primary indication for pacing was permanent complete atrioventricular block with preserved sinus node function in 78.0%. Early major complications occurred in 24 patients (2.4%), including 8 cases (0.8%) of pericardial effusion (3 of which required cardiac surgery), femoral access site complications (0.8%), and thrombosis/embolism (0.3%), with two device-related deaths (0.2%) overall. Late major complications occurred in 40 patients (4.0%), including pacemaker syndrome (2.5%), pacing-induced cardiomyopathy (1.2%), and premature battery depletion (0.2%). No Micra device infections or dislodgement were reported. Overall, 2.5% of patients required device revision, and 12.7% of devices were permanently programmed to VVI(R) mode. Conclusion Despite inconsistent AV synchrony, the Micra AV system demonstrated reasonable safety and efficacy, making it a viable alternative for patients unsuitable for transvenous pacing.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/europace/euaf085.562
Availability: https://doi.org/10.1093/europace/euaf085.562; https://academic.oup.com/europace/article-pdf/27/Supplement_1/euaf085.562/63305599/euaf085.562.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.CC70E7F9
Database: BASE