Programming optimization by increasing the sensing threshold resolved mechanically mediated intermittent oversensing between sequential Micra devices, avoiding invasive revision.
Case Report (n=1)
Does programming optimization resolve mechanically mediated device-device interaction in patients with sequential Micra devices?
Programming optimization by increasing the sensing threshold can resolve mechanically mediated oversensing between sequential leadless pacemakers, avoiding invasive repositioning.
Abstract Background The Micra transcatheter pacing system provides a leadless alternative for patients requiring ventricular pacing. When a leadless device reaches end of service or fails prematurely, a second device is commonly implanted. Case presentation We report a 91-year-old man with premature Micra AV battery depletion 28 months after implantation. During the second implantation, mechanically mediated device–device interaction caused intermittent oversensing. Oversensing was resolved by increasing the sensing threshold, which avoided device repositioning or retrieval. Conclusion Suspected mechanically mediated interaction between sequential Micra devices may cause oversensing and pacing inhibition. In patients with clinically stable condition and adequate intrinsic R-wave amplitude, programming optimization may be considered before invasive revision; however, future management should account for cumulative right ventricular device burden.
何昌见 et al. (Wed,) conducted a case report in Premature Micra AV battery depletion requiring a second device (n=1). Programming optimization (increasing sensing threshold) was evaluated on Resolution of intermittent oversensing. Programming optimization by increasing the sensing threshold resolved mechanically mediated intermittent oversensing between sequential Micra devices, avoiding invasive revision.