What question did this study set out to answer?

This research aims to assess the effectiveness of heterologous atrial-only leadless pacemaker implantation in patients experiencing pacemaker syndrome.

July 18, 2026JACC Case Reports0 citationsOpen Access

View Full Paper

Heterologous Atrial-Only Leadless Rescue of Pacemaker Syndrome With Preserved Atrioventricular Conduction

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Pacemaker syndrome (n=1). Intervention: Abbott Aveir atrial leadless pacemaker implantation. Primary outcome: Ventricular pacing percentage and symptom resolution.

BSBadal SojitraFlorida Center for Gastroenterology SGShiv GakharHCA Healthcare BSBaylen ShoemakerFlorida Center for Gastroenterology

Key Result

Heterologous atrial-only leadless rescue using an Abbott Aveir atrial LP reduced ventricular pacing from 100% to 0.1% and resolved symptoms of pacemaker syndrome without device extraction.

Key Points

This research aims to assess the effectiveness of heterologous atrial-only leadless pacemaker implantation in patients experiencing pacemaker syndrome.
Patient had a Micra AV leadless pacemaker implanted and developed symptoms leading to a second atrial-only leadless pacemaker implantation.
Electrocardiography and exercise testing were conducted to assess conduction and pacing effectiveness.
Mechanical sensing was used to monitor atrioventricular synchrony throughout the study.
Ventricular pacing reduced to 0.1%, indicating significant improvement in pacing efficiency.
Atrial-only leadless rescue resolved symptoms of exertional dyspnea without the need for device extraction.
Provocative testing effectively identified patients suitable for this intervention.

Study Design

Type

Case Report (n=1)

Structured PICO

Does heterologous atrial-only leadless rescue improve symptoms and reduce ventricular pacing in a patient with pacemaker syndrome and preserved antegrade conduction?

Population

A 61-year-old woman with pacemaker syndrome after Micra AV leadless pacemaker implantation who underwent heterologous atrial-only leadless rescue.

Intervention

Abbott Aveir atrial leadless pacemaker implantation (heterologous atrial-only leadless rescue) with retention of prior Micra LP as low-rate ventricular backup.

Outcome

Reduction in ventricular pacing and resolution of symptoms.patient reported

Heterologous atrial-only leadless rescue can restore atrioventricular synchrony and resolve pacemaker syndrome in select patients with preserved antegrade conduction without requiring device extraction.

Main Result

Absolute Event Rate: 0.1% vs 100%

Abstract

BACKGROUND: The Medtronic Micra AV leadless pacemaker (LP) can preserve atrioventricular synchrony via accelerometer-based mechanical sensing; however, tracking limitations may result in pacemaker syndrome. CASE SUMMARY: A 61-year-old woman underwent Micra AV LP implantation for symptomatic postoperative junctional bradycardia after redo aortic root and bioprosthetic aortic valve replacement for prosthetic valve endocarditis, which was complicated by postoperative stroke and recurrent infections. She developed persistent exertional dyspnea despite recovery of left ventricular function and normal prosthetic valve function. Interrogation showed 100% ventricular pacing; electrocardiography showed retrograde P waves; and exercise testing identified preserved antegrade conduction. An Abbott Aveir atrial LP was implanted to restore atrioventricular synchrony, whereas the prior Micra LP was retained as low-rate ventricular backup. DISCUSSION: Atrial-only leadless rescue reduced ventricular pacing to 0.1% and resolved symptoms without transvenous upgrade or prior device extraction. TAKE-HOME MESSAGE: Provocative testing can identify select patients in whom heterologous atrial-only leadless rescue may restore synchrony without extraction.

KI fragen

Bookmark

View Full Paper

KI fragen

Bookmark

View Full Paper

Heterologous Atrial-Only Leadless Rescue of Pacemaker Syndrome With Preserved Atrioventricular Conduction

Key Result

Key Points

Study Design

Structured PICO

Main Result

Abstract

Cite This Study

Also Consider

Also Consider