Key result
Upgrading a leadless pacemaker to CRT appears feasible and complication-free in 3 cases.
Why the study?
An efficient method to upgrade patients with pacing-induced cardiomyopathy from a leadless pacemaker to cardiac resynchronization therapy was needed.
Does upgrading to a synchronized conventional biventricular pacemaker improve clinical status and provide safe cardiac resynchronization therapy in patients with pacing-induced cardiomyopathy and a leadless pacemaker?
Case Report (n=3)
Does upgrading to a synchronized conventional biventricular pacemaker improve clinical status and provide safe cardiac resynchronization therapy in patients with pacing-induced cardiomyopathy and a leadless pacemaker?
Upgrading patients with pacing-induced cardiomyopathy from a leadless pacemaker to cardiac resynchronization therapy using a synchronized conventional biventricular pacemaker is feasible and safe.
May support synchronized upgrades in select cases; leaves open whether clinical benefit or durable resynchronization occurs in pacing-induced cardiomyopathy.
INTRODUCTION: We sought to develop an efficient method to upgrade pacing-induced cardiomyopathy (PICM) patients from a leadless pacemaker (LPM) to cardiac resynchronization therapy. METHODS AND RESULTS: Three consecutive patients with chronic atrial fibrillation, implanted with an LPM, with permanent right ventricular pacing, and who developed left ventricular systolic dysfunction due to PICM, were included. A conventional biventricular pacemaker with two different coronary sinus leads, one used for left lateral ventricular pacing, one for early right ventricular sensing, was implanted. It was then synchronized with the LPM working as the right ventricular pacing lead to provide biventricular pacing. The upgrading technique was feasible in all cases, without any perioperative complication. All patients had an improved clinical status during follow-up. CONCLUSION: This new upgrading technique allows efficient cardiac resynchronization therapy in LPM patients while preventing tricuspid valve crossing and providing an increased battery longevity.
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Lacour et al. (2019) conducted a case report in Pacing-induced cardiomyopathy (n=3). Upgrading to cardiac resynchronization therapy using a conventional biventricular pacemaker synchronized with a leadless pacemaker was evaluated on Feasibility of upgrading technique and perioperative complications. Upgrading a leadless pacemaker to cardiac resynchronization therapy using a conventional biventricular pacemaker synchronized with the leadless pacemaker was feasible in 100% of cases (3/3) without complications.
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