PDF(Pubmed)
Abstract：
BACKGROUND: Lead dislodgements, tricuspid valve failure, and wound infections are prominent issues addressed by leadless pacemakers (LPM). These devises have emerged as viable alternatives to conventional transvenous pacemakers. LPMs offer minimized complications and effective pacing, particularly beneficial for elderly patients with a low body mass index (BMI) who are at heightened infection of risk. The Micra AV leadless pacemaker was released in the US in 2020, featuring a VDD pacing mode akin to conventional pacemakers. It senses atrial activity to pace ventricular beats while maintaining the natural atrioventricular activation sequence. Micra AV achieves atrioventricular synchronization through mechanical sensing principles. Ongoing research aims to assess its efficacy, implantation feasibility, and clinical safety.
METHODS: An 83-year-old man with a history of syncope was the focus of this case study. An implantable cardiac monitor (ICM) recorded occasional high-degree atrioventricular block in the patient. Subsequently, the Micra AV was implanted via the left femoral vein, and its settings were adjusted in accordance with data obtained from the ICM. No significant issues regarding pacing threshold or impedance were found during the follow-up examinations post-surgery. Importantly, the patient experienced a noticeable reduction in symptoms compared to before the implantation.
CONCLUSIONS: This case underscores the significance of ICM monitoring in elucidating cardiac events leading to syncope and guiding appropriate treatment. It also highlights the successful outcomes and reliable implantation of the Micra AV for managing high-degree atrioventricular block. This study contributes to the growing body of evidence supporting the adoption of leadless pacemakers as a viable option for patients requiring cardiac pacing, particularly those vulnerable to complications associated with traditional pacemakers. It provides real-world evidence of Micra AV\'s efficacy and safety, further validating its role in clinical practice.
METHODS: An 83-year-old man with a history of syncope was the focus of this case study. An implantable cardiac monitor (ICM) recorded occasional high-degree atrioventricular block in the patient. Subsequently, the Micra AV was implanted via the left femoral vein, and its settings were adjusted in accordance with data obtained from the ICM. No significant issues regarding pacing threshold or impedance were found during the follow-up examinations post-surgery. Importantly, the patient experienced a noticeable reduction in symptoms compared to before the implantation.
CONCLUSIONS: This case underscores the significance of ICM monitoring in elucidating cardiac events leading to syncope and guiding appropriate treatment. It also highlights the successful outcomes and reliable implantation of the Micra AV for managing high-degree atrioventricular block. This study contributes to the growing body of evidence supporting the adoption of leadless pacemakers as a viable option for patients requiring cardiac pacing, particularly those vulnerable to complications associated with traditional pacemakers. It provides real-world evidence of Micra AV\'s efficacy and safety, further validating its role in clinical practice.
摘要：
背景：铅移位，三尖瓣失效,和伤口感染是无铅起搏器（LPM）解决的突出问题。这些装置已成为常规经静脉起搏器的可行替代方案。LPM提供最小化的并发症和有效的起搏，对低体重指数(BMI)感染风险升高的老年患者尤其有益。MicraAV无引线起搏器于2020年在美国发布，具有类似于传统起搏器的VDD起搏模式。它感知心房活动以起搏心室搏动，同时保持自然的房室激活顺序。MicraAV通过机械传感原理实现房室同步。正在进行的研究旨在评估其功效，植入可行性，和临床安全。
方法：本病例研究的重点是一名83岁有晕厥病史的男性。植入式心脏监护仪（ICM）记录了患者偶尔出现的高度房室传导阻滞。随后，通过左股静脉植入Micra房室,并根据从ICM获得的数据调整其设置。在手术后的随访检查中未发现有关起搏阈值或阻抗的重大问题。重要的是,与植入前相比，患者的症状明显减轻。
结论：该病例强调了ICM监测在阐明导致晕厥的心脏事件和指导适当治疗方面的重要性。它还强调了MicraAV治疗高度房室传导阻滞的成功结果和可靠植入。这项研究有助于越来越多的证据支持采用无引线起搏器作为需要心脏起搏的患者的可行选择。特别是那些容易出现与传统起搏器相关的并发症的人。它提供了MicraAV的疗效和安全性的真实证据，进一步验证其在临床实践中的作用。
方法：本病例研究的重点是一名83岁有晕厥病史的男性。植入式心脏监护仪（ICM）记录了患者偶尔出现的高度房室传导阻滞。随后，通过左股静脉植入Micra房室,并根据从ICM获得的数据调整其设置。在手术后的随访检查中未发现有关起搏阈值或阻抗的重大问题。重要的是,与植入前相比，患者的症状明显减轻。
结论：该病例强调了ICM监测在阐明导致晕厥的心脏事件和指导适当治疗方面的重要性。它还强调了MicraAV治疗高度房室传导阻滞的成功结果和可靠植入。这项研究有助于越来越多的证据支持采用无引线起搏器作为需要心脏起搏的患者的可行选择。特别是那些容易出现与传统起搏器相关的并发症的人。它提供了MicraAV的疗效和安全性的真实证据，进一步验证其在临床实践中的作用。
