Switching a leadless pacemaker to AAI+VVI mode in a sinus node dysfunction patient increased atrial pacing to 99%, reduced ventricular pacing to <1%, and extended battery life by 4-5 years.
Case Report (n=1)
No
Does reprogramming a dual-chamber leadless pacemaker to AAI + VVI mode improve symptoms and pacing parameters in a patient with sinus node dysfunction and poor implant-to-implant communication?
In a patient with sinus node dysfunction and poor implant-to-implant communication, programming a dual-chamber leadless pacemaker to AAI + VVI mode resolved pacemaker syndrome and minimized unnecessary ventricular pacing.
Absolute Event Rate: 99% vs 54%
Leadless cardiac pacing integrates all components into a single intracardiac capsule under one cubic centimeter, attached directly to the endocardium 1.Patients diagnosed with sinus node dysfunction (SND) or atrioventricular (AV) block, who are at high risk of infections, post-lead extractions, valve repair or with limited vascular access, requiring AV synchrony, can be offered a dual-chamber (DC) leadless pacemaker (LPM) 1-3.At present DC LPM achieve AV synchrony through implant-to-implant (i2i) communication using low-energy electrical pulses, maintaining physiological AV delay comparable to traditional DDD pacing system 4.However, i2i communication, depending on atrial and ventricular LPMs distance, may require additional optimization steps to ensure appropriate pacing percentage and optimal battery longevity 4, 5.
Winkler et al. (Fri,) conducted a case report in Sinus node dysfunction (n=1). AAI + VVI mode programming (Aveir DR leadless pacemaker) vs. DDDR mode programming was evaluated on Atrial pacing (Ap) percentage. Switching a leadless pacemaker to AAI+VVI mode in a sinus node dysfunction patient increased atrial pacing to 99%, reduced ventricular pacing to <1%, and extended battery life by 4-5 years.