Risk Stratification for Pericardial Effusion After Leadless Pacemaker Implantation ― Multicenter Study ―
Abstract
BACKGROUND: Postoperative pericardial effusion (PPE) is a known complication associated with the use of leadless pacemakers (LPMs). The risk score (RS) is a useful tool for risk stratification. This study evaluated the utility of risk stratification using the RS in Japanese patients who received the Micra LPM. METHODS AND RESULTS: We retrospectively enrolled 443 patients who received Micra LPMs that were implanted at 4 institutions between August 2017 and August 2024. Patients were risk stratified using the RS into 3 groups: low risk (score ≤0), intermediate risk (score 1), and high risk (score ≥2). PPEs were observed in 9.0% (20/221), 11.7% (9/77) and 17.9% (26/145) of patients in the low-, intermediate-, and high-risk groups, respectively (P=0.041). In multivariable analysis, chronic obstructive pulmonary disease was a significant risk factor (P=0.014) for PPE, whereas prior cardiac surgery significantly reduced the risk of PPE (P=0.023). Older age, being female, and hemodialysis were not identified as risk factors. Subsequently, we modified the RS (mRS). Using the mRS, PPEs were observed in 8.8% (27/306), 16.5% (14/85), and 26.9% (14/52) of patients in the low-, intermediate-, and high-risk groups, respectively (P<0.001). CONCLUSIONS: The original RS is useful for PPE risk stratification after Micra LPM implantation. However, the mRS provides better risk discrimination and may therefore be a more suitable tool for use in the Japanese population.
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BibTeX
@article{komai2026risk,
title = {{Risk Stratification for Pericardial Effusion After Leadless Pacemaker Implantation ― Multicenter Study ―}},
author = {Yuya Komai and Hitoshi Minamiguchi and Masayuki Ishimura and Yuichiro Sakamoto and Masahiro Nakano and Takatsugu Kajiyama and Miyo Nakano and Toshinori Chiba and Satoko Ryuzaki and Yukiko Takanashi and Yusei Nishikawa and Takashi Kanda and Mikiko Matsumura and Naoki Mori and Yuma Hamanaka and Takashige Sakio and Yuki Shibuya and Daisuke Yoshimoto and Yuko Uemura and Shoko Narumi and Yoshio Kobayashi and Yusuke Kondo},
journal = {Circulation Journal},
year = {2026},
month = oct,
doi = {10.1253/circj.cj-25-1061},
url = {https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-25-1061/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Risk Stratification for Pericardial Effusion After Leadless Pacemaker Implantation ― Multicenter Study ―
AU - Yuya Komai
AU - Hitoshi Minamiguchi
AU - Masayuki Ishimura
AU - Yuichiro Sakamoto
AU - Masahiro Nakano
AU - Takatsugu Kajiyama
AU - Miyo Nakano
AU - Toshinori Chiba
AU - Satoko Ryuzaki
AU - Yukiko Takanashi
AU - Yusei Nishikawa
AU - Takashi Kanda
AU - Mikiko Matsumura
AU - Naoki Mori
AU - Yuma Hamanaka
AU - Takashige Sakio
AU - Yuki Shibuya
AU - Daisuke Yoshimoto
AU - Yuko Uemura
AU - Shoko Narumi
AU - Yoshio Kobayashi
AU - Yusuke Kondo
PY - 2026
DA - 2026/10/03
JO - Circulation Journal
DO - 10.1253/circj.cj-25-1061
UR - https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-25-1061/_article
AB - BACKGROUND: Postoperative pericardial effusion (PPE) is a known complication associated with the use of leadless pacemakers (LPMs). The risk score (RS) is a useful tool for risk stratification. This study evaluated the utility of risk stratification using the RS in Japanese patients who received the Micra LPM. METHODS AND RESULTS: We retrospectively enrolled 443 patients who received Micra LPMs that were implanted at 4 institutions between August 2017 and August 2024. Patients were risk stratified using the RS into 3 groups: low risk (score ≤0), intermediate risk (score 1), and high risk (score ≥2). PPEs were observed in 9.0% (20/221), 11.7% (9/77) and 17.9% (26/145) of patients in the low-, intermediate-, and high-risk groups, respectively (P=0.041). In multivariable analysis, chronic obstructive pulmonary disease was a significant risk factor (P=0.014) for PPE, whereas prior cardiac surgery significantly reduced the risk of PPE (P=0.023). Older age, being female, and hemodialysis were not identified as risk factors. Subsequently, we modified the RS (mRS). Using the mRS, PPEs were observed in 8.8% (27/306), 16.5% (14/85), and 26.9% (14/52) of patients in the low-, intermediate-, and high-risk groups, respectively (P<0.001). CONCLUSIONS: The original RS is useful for PPE risk stratification after Micra LPM implantation. However, the mRS provides better risk discrimination and may therefore be a more suitable tool for use in the Japanese population.
SN - 1347-4820
SN - 1346-9843
ER -