To evaluate the safety and efficacy of leadless pacemaker by analyze the medium to long-term follow-up results from a single center.

Patients underwent the leadless pacemaker in Heart Center of Zhejiang Greentown Cardiovascular Hospital from December 2019 to May 2021 were enrolled. The indication, operation time, X-ray exposure time were recorded. The pacing parameters (threshold, amplitude, impedance) and adverse events were collected during procedure, before discharge and 1, 3, 6, 12 months after implantation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP) and left ventricular ejection fraction (LVEF) were analyzed as well.

Totally 20 patients were enrolled with successful pacemaker implantation. The average age was (70.56±16.39) years old. And 8 patients (40%) were male. The average operation time was (39.60±12.97) minutes, and the average X-ray exposure time was (6.31±3.32) minutes. The average X-ray exposure was (151.30±34.95) mGy. The parameters during procedure: the average impedance was (764±181) Ω, the average amplitude was (9.0±2.5) mV , and the average threshold was (0.53±0.17) V/0.24 ms. One patient suffered mild pericardial effusion during peri-operation period and improved by conservative treatment. All patients finished 12 months follow-up, and 4 of which finished 24 months. The average follow-up time is (19.0±7.4) months. The electrical parameters were stable during follow-up, and no complication occurred. The pace percent of three cases was greater than 40%. LVEF decreased mildly with no statistical significance (61.5% vs. 59.7%, P=0.05). NT-proBNP was increased (335.6 pg/ml vs. 507.5 pg/ml, P <0.05). The LVEF and NT-proBNP of the remaining patients had no obvious change.

Leadless pacemaker can be safely and effectively used in patients with bradycardia. Heart function can be one of the follow-up contents in patient with high pace percent.