A Meta-analysis for Major Complications Between Traditional Pacemaker and Leadless Pacemaker
Abstract Objectives To compare the major complications between leadless pacemaker (LP) and traditional pacemakers(TP).Background The TP shows some advantages in avoiding pocket- and lead-related complications over the TP and is increasingly used in clinical practice. However, the clinical effect of LP remains controversial.Methods PUBMED、EMBASE、The COCHRANE LIBRARY、CNKI and WANGFANG databases were searched from July 2013 to August 2018. Data concerning the study’s design, patients’ characteristics and outcomes were extracted. The primary end-point is the major complications. The second end-points are elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events.Results A total of 6 studies fulfilled the inclusion criteria. Only 4 of which can provide the data of major complications. The main complications of LP were statistically significantly decreased compared with that of TP(OR 0.41,95%CI:0.29-0.56,P<0.00001,I2=42%).We extracted the data of elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events in 4 other of these 6 studies. There was no significant difference in elevated pacing threshold (OR 0.95, 95%CI:0.24-3.70,P=0.94, I2=31%), cardiac perforation/effusion(OR 1.78,95%CI:0.33-9.58, P=0.50,I2=87%), vascular events (OR1.58, 95%CI:0.45-5.53, P=0.47,I2=47%) and device dislodgement(OR 0.22,95%CI:0.01-5.69,P=0.36,I2=81%) between LP and TP.Conclusion Compared with TP, LP showed a significantly decreased risk in major complications. This indicates that LP has a good prospect to be applicated in clinical practice.