Rendimiento del marcapasos cardiaco Micra en nonagenarios

Introduction and objectives: The Micra transcatheter pacing system has shown high effectiveness and a lower complication rate than conventional transvenous pacemakers. However, the benefit of the device is unknown in the very old population (>= 90 years). The aim of this study was to evaluate the safety and effectiveness of Micra in patients >= 90 years. Methods: We present a prospective observational study with consecutive patients aged > 70 years who underwent implantation of a Micra pacemaker system. Patients were divided into 2 groups: >= 90 and < 90 years. Results: The Micra system was implanted in 129 patients, of whom 41 were aged >= 90 years and 88 < 90 years. The device was successfully implanted in 40 (97.6%) patients >= 90 years and in 87 (98.9%) patients < 90 years (P = .58). An adequate position was achieved with need for <= 2 repositions in 97.5% and 91.9% of patients, respectively (P = .32). Procedure time (26.1 +/- 11.6 vs 30.3 +/- 14.2 minutes; P = .11) and fluoroscopy time (6.4 +/- 4.7 vs 7.2 +/- 4.9 minutes; P = 0.41) were similar in the 2 groups. There were 3 major complications (2.3%), all in the group aged < 90 years: 1 cardiac perforation, 1 femoral hematoma, and 1 femoral pseudoaneurysm. Thirteen patients aged >= 90 years (31.7%) and 16 patients aged < 90 years (18.2%) died during a mean follow-up of 230 +/- 233 days and 394 +/- 285 days, respectively. There were no device-related deaths. No infection, dislocation or migration of Micra were observed. The electrical performance was optimal at follow-up. Conclusions: The Micra leadless pacing system seems to be safe and effective in patients older than 90 years. It may be considered a reasonable alternative to conventional transvenous pacing in this population. (C) 2019 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.