Novel use of an atrial sensing leadless pacemaker to treat complete heart block in a patient with repaired tetralogy of Fallot with pre-existing dual-chamber pacemaker with ventricular lead fracture

Needleman, Matthew; Symons, John; Weber, Lauren; Mulreany, Michael; May, Joseph W.; Haigney, Mark C.

doi:10.1016/j.hrcr.2020.07.019

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…At present, reported experiences with the Micra-AV are scarce, due to its recent introduction on the market, although these reports have shown how Micra-AV can be taken into account as a reasonable choice in peculiar clinical contests. Specifically, the Micra-AV has been presented as a feasible choice in patients with a dual chamber transvenous PM programmed to AAI pacing, due to a RV lead malfunctioning [16][17][18]. This is particularly true for patients at high-risk for lead extraction or for addition of further standard transvenous leads.…”

Section: Micra-av In a Real-life Settingmentioning

confidence: 99%

Atrioventricular synchronous leadless pacemaker: state of art and broadened indications

Mitacchione

Schiavone

Gasperetti

et al. 2021

Reviews in Cardiovascular Medicine

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Leadless pacemakers (LLPMs) have become a major breakthrough in the management of bradyarrhythmia as an attractive alternative to the standard transvenous pacemakers (TV-PMs). Recently, the introduction of a second-generation LLPMs (Micra AV-MC1AVR1) has expanded pacing modes to obtain atrioventricular (AV) synchronous pacing, providing an interesting alternative in the actual scenario of leadless pacing. Nevertheless, actual reports have highlighted some concerns regarding those devices. In this review, we sought to provide an overview of this technology based on its approval studies and major reports.

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Section: Micra-av In a Real-life Settingmentioning

confidence: 99%

Atrioventricular synchronous leadless pacemaker: state of art and broadened indications

Mitacchione

Schiavone

Gasperetti

et al. 2021

Reviews in Cardiovascular Medicine

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show abstract

“…Atrial and ventricular pacing may be present due to atriotomy scars or atrial arrhythmia ablations with subsequent sinus node dysfunction or may have a ventricular septal defect or altered His‐Purkinje anatomy due to their underlying defect 1,2 . The Micra (Medtronic) leadless pacemaker use has been described in adult congenital patients with repaired or unrepaired congenital heart disease 3–5 . We present the first description of two separate types of leadless pacing devices used in the same patient with complex congenital anatomy with moderate tricuspid regurgitation and requiring atrial and ventricular pacing who was a complex prohibitive risk for a standard permanent pacemaker.…”

Section: Introductionmentioning

confidence: 99%

Different leadless pacemakers working in harmony (Aveir in the atrium/Micra AV2 in the ventricle) in a patient with dextrocardia and double outlet right ventricle after high‐risk infected device extraction

English,

Fan,

Ing

et al. 2024

Cardiovasc electrophysiol

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IntroductionPatients with congenital heart disease are at increased risk for requiring cardiac pacing during their lifetime.MethodsWe present the first described case of using two leadless pacing systems manufactured by separate companies implanted within the same patient to provide atrial and ventricular pacing due to complex congenital anatomy.ResultsA 27‐year‐old male with dextrocardia with double outlet right ventricle, subaortic ventricular septal defect, and pulmonary stenosis status‐post pulmonary valve replacement complicated by ventricular pacing dependence and subsequent atrial pacing dependence after atriotomy‐based atypical flutter ablation developed recurrent mediastinitis and pocket infection with erosion despite prolonged antibiotic treatment. Due to atrial and ventricular pacing dependence, a comprehensive congenital care team concluded the need for lead extraction and replacement of pacemaker via leadless peacemaking device. Laser‐lead extraction and temporary atrial pacemaker placement was performed. Afterward, a transesophageal echocardiogram guided implantation of both a Micra AV 2 (Medtronic) leadless pacemaker in the interventricular septum within the right ventricle and an Aveir (Abbott) leadless pacemaker in the superior base of the right atrial appendage was performed with successful pacing. Although there is no communication between these devices, atrial‐mechanical ventricular pacing was reliable with good implant thresholds, impedances and sensing from both devices.ConclusionOur case demonstrates the feasibility of using dual leadless pacing modalities to simultaneously pace someone at complex, prohibitive risk for temporary permanent or permanent pacemaker devices.

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Leadless Pacemakers in Patients with Congenital Heart Disease

Sherwin¹,

Shah²

2023

Cardiac Electrophysiology Clinics

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Novel use of an atrial sensing leadless pacemaker to treat complete heart block in a patient with repaired tetralogy of Fallot with pre-existing dual-chamber pacemaker with ventricular lead fracture

Cited by 4 publications

References 4 publications

Atrioventricular synchronous leadless pacemaker: state of art and broadened indications

Atrioventricular synchronous leadless pacemaker: state of art and broadened indications

Different leadless pacemakers working in harmony (Aveir in the atrium/Micra AV2 in the ventricle) in a patient with dextrocardia and double outlet right ventricle after high‐risk infected device extraction

Leadless Pacemakers in Patients with Congenital Heart Disease

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