Cor Vasa 2026, 68(1):31-38 | DOI: 10.33678/cor.2025.072

Comparing Patient-Reported Quality of Life in Leadless Pacemakers versus Conventional Pacemakers: A Systematic Review

Moses Orvin Revianoa, Rerdin Julariob
a Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
b Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia

Background: Conventional pacemakers (C-PM) are recommended for permanent pacemaker implantation, but developments have led to leadless pacemakers (L-PM). Evolving clinical guidelines support quality of life (QoL) in pacemaker selection, with L-PM hypothesized to offer better QoL by minimizing lead-based complications, but variability in patient selection criteria complicates this. This systematic review aims to compare patient-reported QoL in L-PM versus C-PM.

Methods: A literature search was done on PubMed, EMBASE, Cochrane CENTRAL, Science Direct, Scopus, ProQuest, Google Scholar, and Wiley Online Library from 2015 to 2025. Included studies compared QoL between L-PM and C-PM using the SF-36 questionnaire. The ROBINS-I tool was used for assessing the risk of bias. Physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS) were the SF-36 questionnaire outcomes analysed.

Results: From 5280 studies, three met the inclusion criteria, encompassing 468 patients, with an overall moderate risk of bias. Baseline QoL showed no significant differences between L-PM versus C-PM (p >0.05). L-PM had significantly higher PCS and MCS at 1 week, better PF, RP, BP, VT, GH, and MCS at 1 and 3 months, and sustained better PF, RP, MH, and PCS at the 6-months than C-PM (p <0.05).

Conclusions: L-PM scored better physical health QoL than C-PM, likely due to less fear of complications and fewer activity restrictions. Mental health superiority is inconsistent across studies, highlighting the need for further research.

Keywords: Artificial, Cardiac pacing, Pacemaker, Quality of life, Questionnaires, Surveys, Systematic review

Received: March 18, 2025; Revised: June 16, 2025; Accepted: June 24, 2025; Prepublished online: June 2, 2012; Published: March 15, 2026  Show citation

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Orvin Reviano M, Julario R. Comparing Patient-Reported Quality of Life in Leadless Pacemakers versus Conventional Pacemakers: A Systematic Review. Cor Vasa. 2026;68(1):31-38. doi: 10.33678/cor.2025.072.
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