Study Findings from Duke University Medical Center Broaden Understanding of Managed Care (Evolution of Tined Leadless Pacemaker Implantation: Patient Selection, Implant Volume, Center Characteristics, and Safety Trends): Managed Care

2026 OCT 26 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on Managed Care are discussed in a new report. According to news reporting from Durham, North Carolina, by NewsRx journalists, research stated, “As leadless pacing approaches a decade in clinical practice, we sought to assess how device complications have changed over time, and how variations in patient, implanter volume, and facility characteristics are associated with these changes. To examine rates of cardiac perforations after leadless pacemaker implantation over time, and the associations between patient, implanter volume, and facility characteristics with these outcomes, including the extent of variation attributable to implanters and facilities.”

The news correspondents obtained a quote from the research from Duke University Medical Center, “Medicare claims linked to a manufacturer’s device registration data were used to identify patients implanted with a tined leadless pacemaker from 2017 to 2024. Patient selection across implanters and facilities was evaluated by examining differences in patient characteristics and their impact on patient-adjusted model estimates. Random-intercept models were fitted to estimate variation attributable to implanters and facilities. Among 46,698 implants, 19,446 (41.6%) were Micra AV; patients had a mean age of 80.4 years and a high Charlson Comorbidity Index (4.7±3.4). Cardiac perforation rates declined over time (adjusted Coefficient -0.13, 95% CI -0.19 - -0.06, p-value <0.01). Higher implanter volume was associated with fewer perforations (OR 0.93 per additional 10 implants, 95% CI 0.88-0.98; p-value <0.01). Differences in patient characteristics across providers and facilities were observed; however, adjustment for these differences did not materially alter the associations between implanters and facility and perforation rates. In Medicare patients with tined leadless pacemakers, cardiac perforation rates declined over time and were lower in those implanted by more experienced implanters.”

According to the news reporters, the research concluded: “Variation in outcomes was more closely associated with implanters than facilities.”

This research has been peer-reviewed.

For more information on this research see: Evolution of Tined Leadless Pacemaker Implantation: Patient Selection, Implant Volume, Center Characteristics, and Safety Trends. Heart Rhythm, 2026. Heart Rhythm can be contacted at: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA. (Elsevier - www.elsevier.com; Heart Rhythm - http://www.journals.elsevier.com/heart-rhythm/)

Our news journalists report that additional information may be obtained by contacting Jonathan P. Piccini, Duke University Medical Center & Duke Clinical Research Institute, Durham, NC, United States. Additional authors for this research include Lucas Higuera, Yunshu Yang, George Crossley and Mikhael F. El-Chami.

Publisher contact information for the journal Heart Rhythm is: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.

(Our reports deliver fact-based news of research and discoveries from around the world.)