Dual-chamber pacing using a hybrid transvenous and leadless pacing approach.
Paul NonaMahmoud AltawilEssaq KhanWaddah MaskounPublished in: Pacing and clinical electrophysiology : PACE (2021)
An elderly gentleman with a dual-chamber pacemaker presented to our institution with symptoms of symptomatic bradycardia and high-grade atrioventricular (AV) block. Device interrogation revealed failure to capture in the right ventricle (RV) lead with bipolar pacing, high RV pacing threshold with unipolar pacing, and high impedance suggesting lead fracture. The atrial lead function was normal. Given his advanced age, gait instability, and dementia, the decision was made to proceed with Micra AV pacemaker implantation, while programming his dual-chamber pacemaker to AAIR mode, thus maintaining AV synchrony by tracking paced atrial impulses and providing ventricular pacing.
Keyphrases
- cardiac resynchronization therapy
- left ventricular
- high grade
- heart failure
- mycobacterium tuberculosis
- catheter ablation
- atrial fibrillation
- mild cognitive impairment
- vena cava
- cognitive impairment
- magnetic resonance imaging
- pulmonary hypertension
- bipolar disorder
- mitral valve
- depressive symptoms
- coronary artery
- decision making
- inferior vena cava
- sleep quality
- community dwelling