Key result
Chest physiotherapy induces pacemaker tachycardia over 100 bpm in Micra AV2 via VVIR mode switch.
Why the study?
Leadless pacemakers in VDD mode provide AV synchrony and rate response, but the impact of accelerometer sensor activity during chest physiotherapy is not well described.
Case Report (n=1)
Chest physiotherapy can cause unexpected pacemaker tachycardia in leadless pacemakers operating in VDD mode due to accelerometer sensor activation.
Answers are grounded in this paper and cite their sources.
May trigger inappropriate VVIR pacing during left-sided chest physiotherapy in Micra AV2 VDD patients; leaves open sensor-specific interactions requiring further study.
INTRODUCTION: Leadless pacemakers (LPM) provide ventricular pacing, atrio-ventricular (AV) synchrony and rate response. BACKGROUND: In the VDD mode, the single-chamber LPM is capable of atrial sensing with additional accelerometer activity sensing rate response. METHODS AND RESULTS: An 85-year-old man with tachy-bradycardia received a Micra AV2 (Medtronic Inc). During chest physiotherapy, pulse rate increased to over 100 bpm during chest percussion when performed on the left side. This was due to VDD mode switching to VVIR pacing when the accelerometer sensor rate exceeded the atrial rate. Inactivation of mode switching prevented rate acceleration. CONCLUSION: Chest physiotherapy caused unexpected rate increase in LPM even in VDD mode.
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Lau et al. (2026) conducted a case report in tachy-bradycardia (n=1). Chest physiotherapy was evaluated on Pulse rate increase. Chest physiotherapy caused an unexpected pulse rate increase to over 100 bpm in a patient with a Micra AV2 leadless pacemaker due to VDD mode switching to VVIR pacing.
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