Key result
Micra leadless pacemaker implantation in the LAA achieves excellent pacing parameters post-atrial switch.
Why the study?
Sinus node disease is common in atrial switch patients and conventional pacing approaches are problematic due to baffle stenosis and systemic right ventricular dysfunction.
Case Report (n=2)
May warrant caution before adoption in atrial switch patients; leaves open need for prospective safety and efficacy data.
Sinus node disease is common in atrial switch patients. Transvenous and ventricular pacing can be problematic due to baffle stenosis and systemic right ventricular dysfunction, respectively. We describe the implantation of Micra™ (Medtronic, USA) leadless pacemakers in the left atrial appendage of two patients previously treated with atrial switch operations. The left atrium was accessed via the left femoral vein using a 24-Fr Drysheath™ (Gore, USA). A Micra™ (Medtronic, USA) device was then implanted using the integrated delivery catheter (see Figure showing appendage injection and final position). Acceptable parameters were achieved in both cases (threshold 0.38 V at 0.24 ms, p 4.5 mV in one case, threshold 0.5 V @0.24 ms, p 1.9 mV in the other). Stability was tested using standard manoeuvres. Clinical follow-up at 6 weeks has again shown excellent pacing parameters in both patients. These are to our knowledge the first described cases of leadless pacemaker implant...
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Mitchell et al. (2021) conducted a case report in Sinus node disease in atrial switch patients (n=2). Micra leadless pacemaker implantation in the left atrial appendage was evaluated on Pacing parameters and stability. Implantation of a Micra leadless pacemaker in the left atrial appendage of two patients with prior atrial switch operations resulted in excellent pacing parameters at 6 weeks follow-up.
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