Atrial Leadless Pacemaker to Replace Atrial Pacing From a Failed Conventional Transvenous Atrial Lead

Figures

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  Figure 1. Presenting Rhythm Showing Atrial and Biventricular Pacing With Suspected Noncapture of Atrial and Retrograde Conduction

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  Figure 2. Underlying Rhythm After Electrophysiology Study With DDDR Pacing and LRL of 50 beats/min Electrophysiology study showed atrial pacing without capture and biventricular pacing at 50 beats/min. VA conduction has been abolished, and some spontaneous atrial activity is now present, which the device is able to sense and track. LRL = lower rate limit; VA = ventriculoatrial.

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  Figure 3. Placement of Leadless Pacemaker in the Right Atrial Appendage Fluoroscopic images showing placement of the Aveir AR leadless pacemaker in the right atrial appendage with intentional positioning close to the existing atrial lead. (A) Right anterior oblique view and (B) left anterior oblique view.

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  Figure 4. Postprocedure Electrocardiogram Demonstrating Atrial-Paced, Ventricular-Paced (AP-VP) Rhythm

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  Figure 5. Simultaneous Device Interrogation Postprocedure (A) Interrogation of the Abbitt Aveir AR leadless pacemaker demonstrating appropriate atrial pacing. (B) Interrogation of the Boston Scientific CRT-P device confirming appropriate sensing of the paced atrial activity from the Aveir device and corresponding biventricular pacing. CRT-P = cardiac resynchronization therapy pacemaker.