Implantation of the Micra transcatheter pacing system: Single Polish center experience with the real costs of hospitalization analysis.

Background: The Micra transcatheter pacing system (TPS) is a miniaturized, single-chamber pacemaker system. Study reported herein is an initial experience with implantation of the Micra TPS. Methods: The leadless pacemaker was implanted in 10 patients with standard indications for a permanent pacemaker implantation. All hospitalization costs were calculated for all patients. Results: The mean age of the patients was 75 +/- 7.1 years, 6 were men and 4 were women. Four patients had permanent atrial fibrillation as the basal rhythm and 6 patients had sinus rhythm. All patients had at least one relative contraindication that precluded the use of a traditional pacing system. Mean intraoperative ventricular sensing amplitude was 10.6 +/- 5.4 mV, impedance 843 +/- 185 ohms, and pacing threshold at 0.24 ms was 0.56 +/- 0.23 V At discharge, those values were 13.9 +/- 5.6 ml; 667 +/- 119 ohms and 0.47 +/- 0.17, respectively. The mean duration of implantation procedure was 82 min, while mean fluoroscopy time was 3.5 min. Two patients developed hematoma at the groin puncture site post-implantation. In 1 case there was a need for erythrocyte mass transfusion and surgical intervention. Mean total time of hospitalization was 26 days and time from procedure to discharge 12 days. Average cost of hospitalization per 1 patient was 11,260. 15 EUR minimal cost was 9,052.68 EUR, while maximal cost was 16,533.18 EUR. Conclusions: Implantation of leadless pacemakers is feasible, safe and provides advantages over the conventional system. Hospitalization costs vary for individual patients in wide range.