At the European Society of Cardiology (ESC) Congress 2025 in Madrid, investigators from Hospital de la Santa Creu i Sant Pau, Barcelona, presented the longest real-world follow-up to date on the Micra leadless pacemaker. The single-center study assessed electrical performance and battery longevity over a nine-year period, offering critical insights into the device’s long-term reliability.

Between August 2015 and April 2024, 459 Micra devices were implanted, with 244 patients followed through scheduled remote monitoring transmissions every six months. The cohort had a mean implantation age of 84.4 years, reflecting an elderly population frequently requiring pacing support.

Results demonstrated that electrical parameters remained consistently stable throughout follow-up. Battery performance was sustained in 97% of patients, with only 3% (7 patients) showing reduced longevity due to high pacing thresholds (>2.0 V at 0.24 ms). Importantly, early depletion was seen only in the first three years and exclusively among those with high output requirements. From the fourth year onward, all patients maintained optimal performance, underscoring the device’s durability.

The study reinforces confidence in leadless pacing technology as a long-term solution for patients, particularly the elderly. Future research will focus on device retrieval or replacement strategies as the first generation of Micra implants approach end of life, and on expanding the role of leadless pacemakers to broader patient groups, including those requiring dual-chamber pacing.