{"id":"b5fbf299d343","type":"article","url":"https://hartvaat.nl/2026/03/30/leadless-atriaal-pacen-geeft-minder-complicaties-dan-transveneus-1-jaars-medicar/","title":"Leadless atriaal pacen geeft minder complicaties dan transveneus — 1-jaars Medicare-data","title_en":"","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["draadloze-pacemaker"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euag072","source_url":"https://doi.org/10.1093/europace/euag072","authors":["Kent R Nilsson","Ulrika Birgersdotter-Green","Shmaila Saleem-Talib","Deepti Bettampadi","Zeyuan Yang","Jorge O Diaz","James K Gabriels","Robert D Schaller","Himanshu H Shukla","Michael Kühne","Mauro Biffi","Daniel Hofer","John Paisey","Yelena Nabutovsky","Christophe Garweg"],"significance":7,"published":"2026-04-30","source_date":"2026-03-30","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/antistolling-bij-kankerpatienten/"],"congress":"","summary_en":"Medicare claims compared 428 AVEIR AR leadless pacemaker recipients with 39,881 dual-chamber transvenous (DCTV) and 389 right-atrial transvenous (RATV) systems for sinus node dysfunction without AV block. At 30 days, complications were lower with AVEIR AR vs DCTV (6.7% vs 9.4%; OR 0.7) and similar to RATV; at 1 year, both overall complications (3.6% vs 8.5%; HR 0.4) and reinterventions were lower than in either transvenous cohort, with comparable mortality. Leadless atrial pacing looks attractive for selected SND patients without AV block.","created":"2026-07-03T10:32:49Z","updated":"2026-07-03T13:31:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Real-worldanalyse van Medicare-claims vergeleek 428 ontvangers van een AVEIR AR leadless pacemaker met 39.881 dual-chamber transveneuze (DCTV) en 389 right-atrial transveneuze (RATV) systemen voor sinusknoopdysfunctie zonder AV-blok. Op 30 dagen waren complicaties lager met AVEIR AR vs DCTV (6,7% vs 9,4%; OR 0,7) en gelijk aan RATV. Op 1 jaar bleven zowel totale complicaties (3,6% vs 8,5%; HR 0,4) als re-interventies lager dan in beide transveneuze cohorten. Sterfte was vergelijkbaar. Leadless atriaal pacen lijkt aantrekkelijk voor geselecteerde SND-patiënten zonder AV-blok.","abstract_original":"BACKGROUND AND AIMS: Leadless pacing was developed to avoid complications inherent to transvenous (TV) pacemakers. Among patients with sinus node dysfunction (SND) without atrioventricular block (AVB), TV systems remain standard therapy. Real-world data have shown favourable safety profiles for leadless vs. TV pacemakers. This study aimed to compare 30-day complications and 1-year outcomes-including complications, device-reinterventions, and all-cause mortality-between AVEIR AR leadless pacemakers (LP) and dual-chamber (DCTV) or right-atrial (RATV) TV pacemakers. METHODS: Medicare fee-for-service claims were analysed to identify patients undergoing de novo AVEIR AR LP or TV pacemaker implantation from January 2024 to March 2025, with ≥1 year of prior and ≥30 days of post-implant continuous enrolment. The DCTV cohort included patients with SND without permanent atrial fibrillation or AVB; the RATV and LP cohorts included all respective recipients. Outcomes included 30-day and 1-year complications, device-reinterventions, and mortality. Comparisons were adjusted using propensity score derived overlap weights. RESULTS: A total of 428 AVEIR AR, 39 881 DCTV, and 389 RATV patients were included. Thirty-day complications were lower with AVEIR AR compared with DCTV (adjusted 6.7% vs. 9.4%; OR = 0.7) and similar to RATV (6.9% vs. 6.7%). At 1 year, overall complications remained lower in AVEIR AR than DCTV (3.6% vs. 8.5%; HR = 0.4) and RATV (3.3% vs. 7.5%; HR = 0.4) cohorts. Device-related complications were reduced vs. DCTV, and reinterventions were reduced vs. both DCTV and RATV. Mortality was comparable across all groups. CONCLUSION: AVEIR AR was associated with fewer long-term complications and reinterventions compared with DCTV and RATV, while 1-year mortality remained similar."}