The implantation of AV leadless pacemaker - a case report.

Pol Merkur Lekarski

Division of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland, Department of Cardiology, Silesian Center for Heart Diseases, Zabrze, Poland.

Published: October 2022

Unlabelled: In early 2020 Food and Drug Administration (FDA) approved Micra AV - a new type of leadless pacemaker with atrioventricular synchrony, to treat patients with atrio-ventricular (AV) blocks. We describe one of the first in Poland case of a patient who was implanted with Micra AV pacemaker.

Case Report: A 38-year-old female patient was admitted to the clinic due to the 29-seconds event of a complete AV block without an escape rhythm and was implanted with a dual chamber pacemaker without any complications. After several months she was admitted again with suspicion of ventricular perforation by the pacemaker electrode and underwent a replacement procedure of both pacemaker's leads. Nevertheless, one week later the patient developed a fever with significantly elevated inflammatory markers. The blood cultures were negative but in the transesophageal echocardiography features of cardiac device-related infective endocarditis were observed. Empirical antibiotic therapy was administered, and the device was removed. The Heart Team qualified the patient for the implantation of a MicraTM AV leadless pacemaker. The procedure was performed without any complications and the device was implanted to the right ventricle. All parameters were correct, and the patient was discharged.

Conclusions: Micra AV may be a feasible and safe option for young patients with paroxysmal AV block after device-related complications.

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