Po-05-017 implant efficiency and clinical performance of aveir vr and micra vr leadless pacemaker: a multicenter comparative analysis of 67 patients

Leadless pacemaker (LP) is a novel pacemaker that has been proven to be effective and safe in many real-world studies; however, the majority of LPs in previous reports were the Medtronic Micra leadless system. We aim to evaluate the efficiency and clinical performance of the Aveir leadless system, a newer LP model, compared to the Micra leadless system. We performed a retrospective analysis of patients in two health care systems (Sparrow Hospital and Ascension Health System, Michigan) who were implanted with LPs between January 1, 2018, and April 1, 2022. Patient characteristics including age, sex, and BMI were collected. The LPs parameters were collected at implantation, 3 months, and 6 months. Wilcoxon rank sum test and Fisher's exact test were used to analyze the data. A total of 67 patients were included in the study, with 41 patients received Micra VR implantation and 26 patients received Aveir VR implantation. All patients completed their 6 months follow up. The mean age was 77 years (SD = 11.6) in the Micra group and 65.7 years (SD = 11.8) in the Aveir group. The mean time in the electrophysiology lab was 41 minutes (SD = 12) in the Micra group and 55 minutes (SD = 11.5) in the Aveir group, with a p-value of 0.008. The mean fluoroscopic time was 6.5 minutes (SD = 2.2) in the Micra group and 11.5 minutes (SD = 4.5) in the Aveir group, with a p-value of < 0.001. The Aveir group had a significantly higher implant pacing threshold compared to the Micra group (0.74 ± 0.34 mA. at pulse width 0.4, 0.5±0.18 mA. at pulse width 0.4, p<0.001), but no difference was found at 3 months and 6 months afterward. There was no significant difference in the R-wave sensing and impedance and pacing percentage at implantation, 3 months, and 6 months follow up. Complication of the procedure include vascular hematoma required surgical intervention in one patient of each group and no lead dislodgement was noted in either group at 6 months. The mean longevity of the Aveir group was significantly longer than the Micra group (18.8 ± 4.3 years versus 7.7 ± 0.75 years, p<0.001). Implantation of Aveir VR requires significantly longer laboratory and fluoroscopic time than in Micra VR , however, Micra VR has much shorter longevity than Aveir VR at 6 months follow up even though pacing percentage are not significantly different. Complications and lead dislodgement are rare. Larger study is necessary to confirm these findings