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Purpose: Real-world safety data on the use of transcatheter pacing systems particularly in very elderly patients is still limited. The aim of this analysis was to investigate the effect of age on the safety and efficacy of leadless pacemaker implant. Methods: From May 2016 through July 2019, 577 patients were implanted with a leadless single-chamber pacemaker according to current pacing indication in 15 Italian cardiologic centers. The population was divided into age quartiles for evaluation, including (1) < 70 years, (2) 70–77 years, (3) 78–83 years, and (4) ≥ 83 years. Procedural data, complications, and electrical parameters were collected at baseline and during the follow-up. Results: Procedural-related complication occurrence was very low (< 1.0%) and similar in the four subgroups according to age even if the older patients were more frail. No cardiac tamponade was reported. Among the groups, no difference was observed in procedural time, fluoroscopy time duration, and electrical parameters (mean pacing impedance: 750 ± 192 and 599 ± 156, mean pacing threshold: 0.7 ± 0.5 and 0.7 ± 0.6, and mean right ventricular sensing 10.7 ± 6.1 and 11.5 ± 4.8 at implant and last follow-up, respectively). Conclusions: The reported data demonstrated a high degree of safety during leadless implant across all patient ages. Procedural complications and device electrical measurements were similar among the different ages. [ABSTRACT FROM AUTHOR]

Abstract: Background: Management of carotid artery stenosis is considered an important strategy for stroke prevention. Carotid artery stenting (CAS) has been introduced as an acceptable alternative to surgical carotid endarterectomy (CEA) in the treatment of internal carotid artery (ICA) stenosis. Objective: Assessment of peri-procedural outcome of CAS in 104 consecutive procedures. Methods: The study included 104 consecutive CAS procedures. Included patients had ⩾50% ICA stenosis in the symptomatic group and ⩾70% stenosis in the asymptomatic group. Procedures were performed in cath. labs of Catania and Ragusa hospitals-Italy. Results: Included procedures were done in 100 consecutive eligible patients with ICA stenosis. Four patients had undergone CAS procedures in both sides in 2 separate sessions. Patients were 71 males and 29 females, mean age was 71.9±7.85years, and 21 patients were ⩾80years old (octogenarians). The majority of patients had asymptomatic ICA stenosis (76%) and was diagnosed accidentally during medical checkup. Twenty-four patients had symptomatic ICA stenosis (ipsilateral TIA or stroke). Technical success was obtained in 103 procedures (99%). Embolic protection devices were used in all succeeded cases. Combined cerebrovascular events had occurred in 5 patients with estimated rate=4.8%. No cases of amaurosis fugax, MI or death had occurred. Adverse events was 4.1% in the symptomatic group and 1.3% in the asymptomatic group with no significant statistical difference (P =0.064). Conclusion: CAS with EPDs seems a feasible and safe procedure and could be performed with an acceptable rate of periprocedural adverse events. [Copyright &y& Elsevier]