Initial results of the new screw-in leadless pacemaker Avier AR

Backgrounds Leadless pacemakers have become a major breakthrough in the management of bradyarrhythmia as an attractive alternative to the standard transvenous pacemakers. We've been able to use new leadless pacemaker (Aveir AR, Abbott, Chicago, IL) since March 2025. Avier AR is the first leadless pacemaker that can be implanted in the right atrium. Aim We report the initial results and short-term follow-up of Aveir AR implantation. Methods We underwent Aveir AR implantation procedures to 51 patients between March 2025 and August 2025. Patient characteristics, implantation procedure success rate, number of deployments, and complications were reviewed. We also examined the progression of Avier AR parameters (threshold, wave height, resistance value). Results The mean ages were 81.8±5.5 years (68-93), 16 men (31.3%). Leadless pacemakers were indicated in 48 patients (94.1%) with sick sinus syndrome and 2 patients (5.9%) with atrioventricular block. AR devices were implanted in 41 cases, with an average procedure time of 34 minutes. Two cases involved upgrades from VR devices, with an average procedure time of 47 minutes. Dual-chamber devices were implanted in 8 cases, with an average procedure time of 40 minutes. The P wave amplitude were 1.1 ± 0.6 mV on the day of surgery, 1.8 ± 1.2 mV the day after surgery, and 2.5 ± 1.1 mV one month after surgery. A significant improvement was observed when comparing the values on the day of surgery to those the day after surgery. Pacing threshold was 3.25 ± 1.6 V/0.4ms on the day of surgery, 0.8 ± 0.6 V/0.4ms the day after surgery, and 0.75 ± 0.6 V/0.4ms one month after surgery. A significant improvement was observed when comparing the values on the day of surgery to those the day after surgery(P<0.01). P wave amplitude and pacing threshold showed no significant changes between the day after surgery and one month after surgery. Impedance values were 343 ± 86 Ω on the day of surgery, 363 ± 67 Ω the day after surgery, and 314 ± 52 Ω one month after surgery, showing no significant change. The implantation was successful in all cases. Leadless pacemaker dislodgement, cardiac tamponade, and pericardial effusion did not occur. One case of wound dehiscence at the puncture site occurred, but improvement was observed following suturing. No cases were required retrieval during the follow-up period. Conclusion Pacing threshold and P wave amplitude improved the day after implantation and remained stable during short-term follow-up. The new atrial leadless pacemaker could be implanted without major complications and was safe and useful.