Leadless vs. Conventional Transvenous Pacemakers in Valve Intervention Patients: A Systematic Review & Meta‐Analysis

In this meta-analysis, LP implantation was associated with reduced ventricular pacing burden, but at the expense of a longer hospital stay and increased mortality risk compared with conventional TVP. No significant differences were observed between the two modalities in terms of rehospitalization, pocket infection, lead/device dislodgement, and vascular complications. These findings suggest that although LP were associated with higher observed mortality, this association is likely driven by selection bias, as leadless devices are preferentially implanted in patients with higher baseline risk and greater comorbidity burden. Randomized controlled trials are needed to clarify the comparative safety of leadless versus TVP while minimizing confounding by indication.