Why the study?
There is limited global experience on the safety of simultaneous implantation of an LAAO device and a leadless pacemaker through the same venous access in elderly patients with comorbidities.
Simultaneous implantation of a left atrial appendage occlusion device and a leadless pacemaker is feasible in a frail, elderly patient with high bleeding risk and tachy-brady syndrome.
Hypothesis-generating for selected frail elderly with dual indications; leaves open safety and should not yet change practice.
Managing atrial fibrillation (AF) in elderly patients with comorbidities is a clinical challenge requiring multiple strategies. They are at high risk of bleeding and thromboembolism requiring alternative approaches such as left atrial appendage occlusion (LAAO). Some of these patients may have symptomatic bradycardia with complete heart block and require permanent pacemaker implantation (PPI). However, there is limited global experience on the safety of simultaneous implantation of both devices through the same venous access. We report a case of simultaneous implantation of LAAO device and leadless pacemaker in a multi-morbid very elderly frail individual with Tachy-brady syndrome and high bleeding risk.
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Kasha et al. (2025) studied this question.
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