Implantation of the Micra transcatheter pacing system: Single Polish center experience with the real costs of hospitalization analysis

• Published in: Cardiology journal Vol. 27; no. 1; pp. 47 - 53
• Main Authors: Grabowski, Marcin, Michalak, Marcin, Gawałko, Monika, Gajda, Sylwia, Cacko, Andrzej, Januszkiewicz, Łukasz, Kołodzińska, Agnieszka, Mitkowski, Przmysław P, Duray, Gabor Z, Opolski, Grzegorz
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 01.01.2020; Via Medica
• Subjects: Cardiac arrhythmia; Cardiology; Catheters; Clinical Cardiology; Contraindications; Health care expenditures; Hospitalization; Pacemakers; Patients; Sinuses; Veins & arteries; procedure cost; complications; hospitalization cost; leadless pacemakers
• ISSN: 1897-5593; 1897-5593; 1898-018X
• DOI: 10.5603/CJ.a2018.0075

The Micra transcatheter pacing system (TPS) is a miniaturized, single-chamber pacemaker system. Study reported herein is an initial experience with implantation of the Micra TPS. The leadless pacemaker was implanted in 10 patients with standard indications for a permanent pacemaker implantation. All hospitalization costs were calculated for all patients. The mean age of the patients was 75 ± 7.1 years, 6 were men and 4 were women. Four patients had permanent atrial fibrillation as the basal rhythm and 6 patients had sinus rhythm. All patients had at least one relative contraindication that precluded the use of a traditional pacing system. Mean intraoperative ventricular sensing amplitude was 10.6 ± 5.4 mV, impedance 843 ± 185 ohms, and pacing threshold at 0.24 ms was 0.56 ± 0.23 V. At discharge, those values were 13.9 ± 5.6 mV, 667 ± 119 ohms and 0.47 ± 0.17, respectively. The mean duration of implantation procedure was 82 min, while mean fluoroscopy time was 3.5 min. Two patients developed hematoma at the groin puncture site post-implantation. In 1 case there was a need for erythrocyte mass transfusion and surgical intervention. Mean total time of hospitalization was 26 days and time from procedure to discharge 12 days. Average cost of hospitalization per 1 patient was 11,260.15 EUR minimal cost was 9,052.68 EUR, while maximal cost was 16,533.18 EUR. Implantation of leadless pacemakers is feasible, safe and provides advantages over the conventional system. Hospitalization costs vary for individual patients in wide range.