A real-world experience of atrioventricular synchronous pacing with leadless ventricular pacemakers.
| Title: | A real-world experience of atrioventricular synchronous pacing with leadless ventricular pacemakers. |
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| Authors: | Kowlgi GN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Tseng AS; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Tempel ND; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Henrich MJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Venkatachalam KL; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.; Scott L; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona, USA.; Shen WK; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona, USA.; Deshmukh AJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Madhavan M; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Lee HC; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Asirvatham SJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Friedman PA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Cha YM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Mulpuru SK; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. |
| Source: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2022 May; Vol. 33 (5), pp. 982-993. Date of Electronic Publication: 2022 Mar 14. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Malden, MA : Blackwell; Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| MeSH Terms: | Pacemaker, Artificial*/adverse effects; Cardiac Pacing, Artificial/adverse effects ; Echocardiography ; Heart Atria ; Heart Ventricles ; Humans ; Retrospective Studies ; Treatment Outcome |
| Abstract: | Aims: The MicraTM transcatheter pacing system (TPS) (Medtronic) is the only leadless pacemaker that promotes atrioventricular (AV) synchrony via accelerometer-based atrial sensing. Data regarding the real-world experience with this novel system are scarce. We sought to characterize patients undergoing MicraTM -AV implants, describe percentage AV synchrony achieved, and analyze the causes for suboptimal AV synchrony.; Methods: In this retrospective cohort study, electronic medical records from 56 consecutive patients undergoing MicraTM -AV implants at the Mayo Clinic sites in Minnesota, Florida, and Arizona with a minimum follow-up of 3 months were reviewed. Demographic data, comorbidities, echocardiographic data, and clinical outcomes were compared among patients with and without atrial synchronous ventricular pacing (AsVP) ≥ 70%.; Results: Sixty-five percent of patients achieved AsVP ≥ 70%. Patients with adequate AsVP had smaller body mass indices, a lower proportion of congestive heart failure, and prior cardiac surgery. Echocardiographic parameters and procedural characteristics were similar across the two groups. Active device troubleshooting was associated with higher AsVP. The likely reasons for low AsVP were small A4-wave amplitude, high ventricular pacing burden, and inadequate device reprogramming. Importantly, in patients with low AsVP, subjective clinical worsening was not noted during follow-up.; Conclusion: With the increasing popularity of leadless pacemakers, it is paramount for device implanting teams to be familiar with common predictors of AV synchrony and troubleshooting with MicraTM -AV devices.; (© 2022 Wiley Periodicals LLC.) |
| Comments: | Comment in: J Cardiovasc Electrophysiol. 2022 May;33(5):994-996. doi: 10.1111/jce.15431.. (PMID: 35233870) |
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| Contributed Indexing: | Keywords: MicraTM transcatheter pacing system; atrial fibrillation; atrioventricular synchrony; leadless pacemaker troubleshooting; pacemaker syndrome |
| Entry Date(s): | Date Created: 20220302 Date Completed: 20220420 Latest Revision: 20220606 |
| Update Code: | 20260130 |
| DOI: | 10.1111/jce.15430 |
| PMID: | 35233867 |
| Database: | MEDLINE |
Journal Article