Systematic Review and Meta-Analysis of Acute Mortality and Complication Rates Following Leadless Pacemaker Placement Using National-Level Data
Sarsenbayeva A. Baimbetov A. Puodziukynas A. Baimakhanov B. Sapunov A. Bizhanov K.
June 2025Multidisciplinary Digital Publishing Institute (MDPI)
Medicina (Lithuania)
2025#61Issue 6
Background and Objectives: Leadless pacemakers provide an innovative alternative to traditional transvenous pacemakers for managing cardiac arrhythmias. The objective of this systematic review is to conduct a meta-analysis comparing acute complication and mortality rates associated with leadless pacemakers versus transvenous pacemaker placements using national-level data. Specifically, we aim to summarize the current evidence and calculate pooled odds ratios for acute overall complications, acute device-related complications, and acute mortality to assess the early safety outcomes of leadless pacemaker placement relative to traditional transvenous pacemakers. Materials and Methods: A systematic search of PubMed, Scopus, ScienceDirect, and Google Scholar was conducted by two independent researchers using a predefined search protocol. The search included articles published up to 10 October 2024, without limits on review depth. Studies were included if they provided national-level data comparing leadless pacemaker and traditional pacemaker recipients in terms of acute mortality, acute overall complications, and acute device-related complications. Outcomes were pooled to calculate odds ratios using a random-effects model in RStudio (version 2024.12.1+563). Results: A total of five studies met the eligibility criteria. The pooled odds ratio for acute mortality was 2.03 (95% CI: 0.65–6.34, I2 = 99%; p < 0.01), for acute overall complications was 1.08 (95% CI: 0.45–2.61, I2 = 99%; p < 0.01), and for acute device-related complications was 1.02 (95% CI: 0.23–4.44, I2 = 99%; p < 0.01). Conclusions: The reviewed studies suggest that leadless pacemakers offer a promising alternative to transvenous pacemakers, offering a comparable short-term safety profile. Ongoing technological advancements may further enhance their applicability in clinical practice.
atrial fibrillation , bradyarrhythmia , cardiac arrhythmia management , cardiac pacing , heart failure , leadless pacemakers , mortality , pacemaker complications , pacemaker outcomes , transvenous pacemakers
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Department of Interventional Cardiology, Arrhythmology and Endovascular Surgery, Syzganov National Scientific Center of Surgery, Almaty, 050004, Kazakhstan
Department of Cardiology, Asfendiyarov Kazakh National Medical University, Almaty, 050012, Kazakhstan
Hospital of Lithuanian University of Health Sciences “Kauno klinikos”, Kaunas, LT-50161, Lithuania
Department of General Surgery, Syzganov National Scientific Center of Surgery, Almaty, 050004, Kazakhstan
Department of Internal Medicine, Asfendiyarov Kazakh National Medical University, Almaty, 050012, Kazakhstan
Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty, 050040, Kazakhstan
Department of Interventional Cardiology
Department of Cardiology
Hospital of Lithuanian University of Health Sciences “Kauno klinikos”
Department of General Surgery
Department of Internal Medicine
Faculty of Medicine and Healthcare
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