Aims: Totally leadless cardiac resynchronization therapy (CRT) can be delivered with a combination of Micra and WiSE-CRT systems. We describe the technical feasibility and first insights into the safety and efficacy of this combination in European experience.
Methods And Results: Patients enrolled had indication for both Micra and WiSE-CRT systems because of heart failure related to high burden of pacing by a Micra necessitating system upgrade or inability to implant a conventional CRT system because of infectious or anatomical conditions. The endpoints of the study were technical success of WiSE-CRT implantation with right ventricle-synchonized CRT delivery, acute QRS duration reduction, and freedom from procedure-related major adverse events. All eight WiSE-CRT devices were able to detect the Micra pacing output and to be trained to deliver synchronous LV endocardial pacing. Acute QRS reduction following WiSE-CRT implantation was observed in all eight patients (mean QRS 204.38 ± 30.26 vs. 137.5 ± 24.75 mS, P = 0.012). Seven patients reached 6 months of follow-up. At 6 months after WiSE-CRT implantation, there was a significant increase in LV ejection fraction (28.43 ± 8.01% vs. 39.71 ± 11.89%; P = 0.018) but no evidence of LV reverse remodelling or improvement in New York Heart Association class.
Conclusion: The Micra and the WiSE-CRT systems can successfully operate together to deliver total leadless CRT to a patient. Moreover, the WiSE-CRT system provides the only means to upgrade the large population of Micra patients to CRT capability without replacing the Micra. The range of application of this combination could broaden in the future with the upcoming developments of leadless cardiac pacing.
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http://dx.doi.org/10.1093/europace/euaa342 | DOI Listing |
JACC Clin Electrophysiol
December 2024
Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA. Electronic address:
J Clin Med
January 2025
Division of Cardiology, Department of Internal Medicine, Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY 13326, USA.
: Leadless pacemakers offer a safe and effective alternative pacing strategy. However, limited data are available for patients with end stage renal disease (ESRD), a population of significant relevance. Using the Nationwide Readmission Database, we extracted data from all adult patients with ESRD who underwent traditional transvenous or leadless pacemaker implantation between 2016 and 2021.
View Article and Find Full Text PDFPacing Clin Electrophysiol
January 2025
Electrophysiology and Cardiac Pacing Unit, San Giuliano Hospital, Giugliano in Campania, Italy.
We present the case of a 64-year-old man who, during the implantation of an active-fixation leadless pacemaker (LP, Aveir VR, Abbott, USA), underwent several external defibrillation shocks up to 240 Joules, due to symptomatic sustained supraventricular tachycardia at 160 bpm. The shocks, delivered both before and after the screwing of the device in the low interventricular septum, did not cause any technical damage to the device, and no complications were observed. The device was then deployed successfully.
View Article and Find Full Text PDFJ Am Coll Cardiol
December 2024
Electrophysiology Section, Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Am Coll Cardiol
December 2024
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Background: The growing use of leadless pacemaker (LP) technology requires safe and effective solutions for retrieving and removing these devices over the long term.
Objectives: This study sought to evaluate retrieval and removal of an active helix-fixation LP studied in worldwide regulatory clinical trials.
Methods: Subjects enrolled in the LEADLESS II phase 1 investigational device exemption, LEADLESS Observational, or LEADLESS Japan trials with an attempted LP retrieval at least 6 weeks postimplantation were included.
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