Gender Differences With Leadless Pacemakers: Periprocedural Complications, Long-Term Device Function, and Clinical Outcomes

Leadless pacemakers (LPs) have emerged as an alternative to transvenous permanent pacemakers (PPMs). LPs reduce the risk of device infection, especially in patients at elevated risk for infectious complications. 1 El-Chami MF Bockstedt L Longacre C Higuera L Stromberg K Crossley G Kowal RC Piccini JP Leadless vs. transvenous single-chamber ventricular pacing in the Micra CED study: 2-year follow-up. Eur Heart J. 2022; 43: 1207-1215 Crossref PubMed Scopus (58) Google Scholar Female patients have historically been underrepresented in clinical device trials. 2 Hohnloser SH Kuck KH Dorian P Roberts RS Hampton JR Hatala R Fain E Gent M Connolly SJ Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004; 351: 2481-2488 Crossref PubMed Scopus (1255) Google Scholar Existing data indicate that clinical outcomes of cardiac implantable electronic devices in female patients are comparable with those in male patients, but female patients may have greater implant-associated complications. 3 Kirkfeldt RE Johansen JB Nohr EA Jorgensen OD Nielsen JC Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark. Eur Heart J. 2014; 35: 1186-1194 Crossref PubMed Scopus (601) Google Scholar However, relatively little is known about gender differences in longer-term outcomes of leadless pacing. The aim of this study is to evaluate gender differences in device-implant complications, long-term device performance, and clinical outcomes with Micra LPs.