A new leadless pacemaker with atrioventricular synchronous pacing replacing a still working VVI leadless pacemaker: a case report.

Atrioventricular block Atrioventricular synchronous pacing Case report Leadless pacemaker Micra TPS Pacemaker syndrome

Journal

European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 21 03 2021
revised: 18 04 2021
accepted: 13 07 2021
entrez: 19 8 2021
pubmed: 20 8 2021
medline: 20 8 2021
Statut: epublish

Résumé

A new intracardiac leadless pacemaker (ILP) has been developed to ensure atrioventricular (AV) synchrony (AVS) during ventricular pacing (VP). Recent studies have shown the feasibility and safety of accelerometer-based atrial sensing and an improvement in AVS among patients with atrioventricular block implanted with the Micra AV ILP (Medtronic Inc., Minneapolis, MN, USA). However, no data exists about the benefits of a VDD ILP in patients wearing a still working VVI Nanostim ILP (St Jude Medical, St Paul, MN, USA). We describe the feasibility of the procedure and the absence of device-related adverse events in the short-term follow-up. We present the case of a 72-year-old man implanted with a VVI ILP (Nanostim, St Jude Medical, St Paul, MN, USA) on May 2014, who has developed symptomatic high percentage of VVI asynchronous pacing and was treated with an upgrade to synchronous AV pacemaker (PM) ILP-Micra AV (Medtronic Inc., Minneapolis, MN, USA), which has improved symptoms and functional class. Intracardiac leadless pacemakers represent the best current option for patients requiring PM implantation who are at high risk of infection and bleeding. Our case shows that the new AVS ILP is a good alternative to VVI ILP in patients with sinus rhythm and a strong need for VP.

Sections du résumé

BACKGROUND BACKGROUND
A new intracardiac leadless pacemaker (ILP) has been developed to ensure atrioventricular (AV) synchrony (AVS) during ventricular pacing (VP). Recent studies have shown the feasibility and safety of accelerometer-based atrial sensing and an improvement in AVS among patients with atrioventricular block implanted with the Micra AV ILP (Medtronic Inc., Minneapolis, MN, USA). However, no data exists about the benefits of a VDD ILP in patients wearing a still working VVI Nanostim ILP (St Jude Medical, St Paul, MN, USA). We describe the feasibility of the procedure and the absence of device-related adverse events in the short-term follow-up.
CASE SUMMARY METHODS
We present the case of a 72-year-old man implanted with a VVI ILP (Nanostim, St Jude Medical, St Paul, MN, USA) on May 2014, who has developed symptomatic high percentage of VVI asynchronous pacing and was treated with an upgrade to synchronous AV pacemaker (PM) ILP-Micra AV (Medtronic Inc., Minneapolis, MN, USA), which has improved symptoms and functional class.
DISCUSSION CONCLUSIONS
Intracardiac leadless pacemakers represent the best current option for patients requiring PM implantation who are at high risk of infection and bleeding. Our case shows that the new AVS ILP is a good alternative to VVI ILP in patients with sinus rhythm and a strong need for VP.

Identifiants

pubmed: 34409251
doi: 10.1093/ehjcr/ytab305
pii: ytab305
pmc: PMC8364773
doi:

Types de publication

Case Reports

Langues

eng

Pagination

ytab305

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

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Auteurs

Massimo Moltrasio (M)

Department of Clinical Electrophysiology and Arrhythmia, Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.

Rita Sicuso (R)

Department of Clinical Electrophysiology and Arrhythmia, Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.

Fabrizio Tundo (F)

Department of Clinical Electrophysiology and Arrhythmia, Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.

Claudio Tondo (C)

Department of Clinical Electrophysiology and Arrhythmia, Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.
Department of Clinical Science and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy.

Classifications MeSH