Predictors of increase in pacing threshold after transcatheter pacing system implantation due to micro‐dislodgement

• Published in: Pacing and clinical electrophysiology 2020-11, Vol.43 (11), p.1351-1357
• Main Authors: Higuchi, Motoaki, Shinoda, Yasutoshi, Hasegawa, Tomoaki, Ishibashi, Mayu, Yamada, Norihiro, Chiba, Yoshiro, Ohira, Koji, Murata, Minoru, Aonuma, Kazutaka
• Format: Article
• Language: English
• Subjects: artificial pacemaker; high pacing threshold; implant; implant impedance; micro‐dislodgement; Myocardium; transcatheter pacing system
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.14080

Background Achieving a favorable pacing threshold with a Micra transcatheter pacing system (Micra‐TPS) is needed to reduce battery depletion. In some cases, the threshold increases shortly after the device is implanted, and a higher pacing threshold may be required. This study aims to identify the causes and predictors of the increase in pacing threshold observed shortly after Micra‐TPS implantation. Methods The study included 64 consecutive patients who underwent Micra‐TPS implantation between 2017 and 2020. The patients were divided into two groups depending on their pacing threshold: the increased pacing threshold (IPT) group (threshold increased by ≥0.5 V/0.24 ms within 1 month of implantation) and the stable pacing threshold (SPT) group. Results Excluding four patients who could not be followed up, of the 60 remaining patients, nine (15%) were in the IPT group and 51 (85%) were in the SPT group. The IPT group had significantly lower implant impedance values and higher implant thresholds than the SPT group (582 ± 59 vs 755 ± 167 Ω [P 660 Ω and threshold