Implant efficiency and clinical performance of Aveir? VR and Micra? VR leadless pacemaker: A multicenter comparative analysis of 67 patients

Introduction: Leadless pacemaker (LP) is a novel pacemaker that has been proven to be effective and safe; however, themajority of LPs in previous reports were the Medtronic Micra (TM) VR LP. We aim to evaluate the implant efficiency and clinical performance of the Aveir (TM) VR LP compared to the Micra (TM) VR LP. Method: We performed a retrospective analysis in two healthcare systems (Sparrow Hospital and Ascension Health System, Michigan) in patients implanted with LPs between January 1, 2018, and April 1, 2022. The parameters were collected at implantation, 3 months and 6 months. Results: A total of 67 patients were included in the study. The Micra (TM) VR group had shorter time in the electrophysiology lab (41 +/- 12 vs. 55 +/- 11.5 min, p = .008) and shorter fluoroscopic time (6.5 +/- 2.2 vs. 11.5 +/- 4.5 min, p < .001) compared to the Aveir (TM) VR group. The Aveir (TM) VR group had a significantly higher implant pacing threshold compared to the Micra (TM) VR group (0.74 +/- 0.34 mA vs. 0.5 +/- 0.18 mA at pulse width 0.4 ms, p < .001), but no difference was found at 3 months and 6 months. There was no significant difference in the R-wave sensing and impedance and pacing percentage at implantation, 3 months, and 6 months. Complications of the procedure were rare. The mean projected longevity of the Aveir (TM) VR group was longer than the Micra (TM) VR group (18.8 +/- 4.3 vs. 7.7 +/- 0.75 years, p < .001). Conclusion: Implantation of the Aveir (TM) VR required longer laboratory and fluoroscopic time, but showed longer longevity at 6 months follow-up, compare to the Micra (TM) VR. Complications and lead dislodgement are rare.