The implantation of AV leadless pacemaker - a case report

Pol Merkur Lekarski. 2022 Oct 21;50(299):299-301.

Abstract

In early 2020 Food and Drug Administration (FDA) approved Micra AV - a new type of leadless pacemaker with atrioventricular synchrony, to treat patients with atrio-ventricular (AV) blocks. We describe one of the first in Poland case of a patient who was implanted with Micra AV pacemaker.

Case report: A 38-year-old female patient was admitted to the clinic due to the 29-seconds event of a complete AV block without an escape rhythm and was implanted with a dual chamber pacemaker without any complications. After several months she was admitted again with suspicion of ventricular perforation by the pacemaker electrode and underwent a replacement procedure of both pacemaker's leads. Nevertheless, one week later the patient developed a fever with significantly elevated inflammatory markers. The blood cultures were negative but in the transesophageal echocardiography features of cardiac device-related infective endocarditis were observed. Empirical antibiotic therapy was administered, and the device was removed. The Heart Team qualified the patient for the implantation of a MicraTM AV leadless pacemaker. The procedure was performed without any complications and the device was implanted to the right ventricle. All parameters were correct, and the patient was discharged.

Conclusions: Micra AV may be a feasible and safe option for young patients with paroxysmal AV block after device-related complications.

Keywords: Micra AV; atrio-ventricular block; atrio-ventricular synchronous pacing; leadless pacemaker.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents
  • Atrioventricular Block* / etiology
  • Atrioventricular Block* / therapy
  • Endocarditis* / complications
  • Female
  • Heart Ventricles
  • Humans
  • Pacemaker, Artificial* / adverse effects

Substances

  • Anti-Bacterial Agents