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. 2025 Aug;68(5):1027-1033.
doi: 10.1007/s10840-024-01936-2. Epub 2024 Oct 22.

Outcomes of leadless pacemaker implantation in the United States based on sex

Muhammad Zia Khan  1 , Bandar Alyami  1 , Waleed Alruwaili  1 , Amanda T Nguyen  2 , Melody Mendez  2 , William E Leon  2 , Justin Devera  2 , Hafiz Muhammad Sohaib Hayat  2 , Abdullah Naveed  3 , Zain Ul Abideen Asad  4 , Siddharth Agarwal  4 , Sudarshan Balla  1 , Douglas Darden  5 , Muhammad Bilal Munir  6
Affiliations

Outcomes of leadless pacemaker implantation in the United States based on sex

Muhammad Zia Khan et al. J Interv Card Electrophysiol. 2025 Aug.

Abstract

Background: To determine differences in baseline characteristics and outcomes of leadless pacemaker implantation based on sex.

Methods: For the purpose of this study, data were extracted from the National Inpatient Sample database for years 2016-2020. The study group was then stratified based on sex. Baseline characteristics and in-hospital outcomes including complications were then analyzed in each group. Multivariable logistic regression models were created to analyze the association of sex with important outcomes of mortality, major complications (defined as pericardial effusion requiring intervention and any vascular complication), prolonged length of stay (defined as > 6 days), and increased cost of hospitalization (defined as median cost > 34,098$) after leadless pacemaker implantation.

Results: A total of 29,000 leadless pacemakers (n in women = 12,960, 44.7%) were implanted during our study period. Women were found to have an increased burden of co-morbidities as compared to men. In the adjusted analysis, the likelihood of mortality (aOR 1.27, 95% CI 1.14-1.43), major complications (aOR 1.07, 95% CI 0.98-1.18), prolonged length of stay (aOR 1.09, 95% CI 1.04-1.15), and increased hospitalization cost (aOR 1.14, 95% CI 1.08-1.20) were higher in women as compared to men after leadless pacemaker implantation.

Conclusion: Important and significant differences exist in leadless pacemaker implantation in women as compared to men. These findings highlight the need for evaluating etiologies behind such differences with a goal of improving outcomes in all patients after leadless pacemaker implantation.

Keywords: Complications; Leadless; Mortality; Outcomes; Pacemaker; Women.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Adjusted association of sex with outcomes of mortality, major complications, prolonged length of stay, and increased hospitalization costs after leadless pacemaker implantation
See this image and copyright information in PMC

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