Leadless atrial pacemaker implantation combined with pre-existing S-ICD using a three-stage perioperative screening protocol resulted in stable sensing vector selection and no S-ICD oversensing events at 1 month follow-up.
Case Report (n=1)
No
Does a three-stage screening strategy prevent pacing-induced S-ICD oversensing during leadless atrial pacemaker implantation in patients with a pre-existing S-ICD?
Highlights the importance of a screening strategy to prevent device-device interaction (oversensing and inappropriate shocks) when combining S-ICD and leadless pacemakers.
The advent of subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPs) has enabled a completely transvenous lead-free strategy for patients requiring bradycardia pacing and defibrillation.1,2 However, this approach requires careful assessment of device-device interaction, particularly pacing-induced S-ICD oversensing, which may result in ineligible screening or inappropriate shocks.3-5 Previous studies have shown that pacing site, pacing output, and R/T-wave morphology significantly influence sensing eligibility.
Wu et al. (Sun,) conducted a case report in 74-year-old woman with hypertrophic cardiomyopathy, history of syncope and ventricular tachycardia, with pre-existing subcutaneous implantable cardioverter-defibrillator and new diagnosis of sick sinus syndrome requiring atrial pacing (n=1). Leadless atrial pacemaker (Aveir AR, Abbott) implantation with pre-existing subcutaneous implantable cardioverter-defibrillator (EMBLEM A209, Boston Scientific) was evaluated on S-ICD sensing compatibility and absence of oversensing events during follow-up after leadless atrial pacemaker implantation. Leadless atrial pacemaker implantation combined with pre-existing S-ICD using a three-stage perioperative screening protocol resulted in stable sensing vector selection and no S-ICD oversensing events at 1 month follow-up.