Abstract 14531: Intracardiac versus Transvenous Pacemaker Implantation: Impact on Clinical Outcomes and Healthcare Utilization

Abstract

Introduction: Permanent pacemakers are frequently used to treat disorders of cardiac rhythms. Recently, intracardiac (leadless) pacemakers offer potential treatment with an alternative insertion procedure due to their novel design. Literature comparing hospitalization outcomes between the devices is scarce. We aim to assess the impact of intracardiac pacemakers on readmissions and hospitalization trends. Methods: We analyzed the National Readmissions Database (NRD) from 2016 to 2019 seeking patients admitted for sick sinus syndrome, second-degree or third-degree AV block who received either a transvenous pacemaker or an intracardiac pacemaker. Patients were stratified by device type and assessed for 30-day readmissions, inpatient mortality, and length of stay. Descriptive statistics, Cox proportional hazards and multivariate regressions were used to compare the groups. Results: During the studied period, 21,782 patients met the inclusion criteria. Transvenous pacemakers were implanted in 17,677 patients and intracardiac pacemakers implanted in 4,017 patients. The mean age was 81.07 years, and 45.52% were female. No statistical difference was noted for readmissions (HR 1.14, 95% CI 0.92 - 1.41, p = 0.225) and inpatient mortality (HR 1.36, 95% CI 0.71 - 2.62, p = 0.352) between transvenous and intracardiac groups. Kaplan-Meier curves for readmission and mortality are presented in Figure 1A and 1B, respectively. Multivariate linear regression revealed that length of stay was 0.54 (95% CI 0.26 - 0.83, p < 0.001) days longer for intracardiac group. Conclusion: Hospitalization outcomes associated with intracardiac pacemakers are comparable to traditional transvenous pacemakers. Patients may benefit from the use of this new device without incurring additional resource utilization. Further studies are needed to compare long term outcomes between transvenous and intracardiac pacemakers.