One stage atrioventricular nodal ablation and leadless pacemaker implantation for refractory atrial fibrillation

Atrioventricular nodal (AVN) ablation and right ventricular (RV) pacing is recommended for refractory atrial fibrillation (AF) and tachycardia‐bradycardia syndrome. Three AF patients (mean age 83, range 79‐89 years) underwent AVN ablation and transvenous leadless pacemaker Micra™ implantations using...

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Bibliographic Details
Published in:Journal of arrhythmia 2019-02, Vol.35 (1), p.139-141
Main Authors: Lau, Chu‐Pak, Lee, Kathy Lai‐Fun
Format: Article
Language:English
Subjects:
ablation
Ablation (Surgery)
Anticoagulants
Atrial fibrillation
Cardiac arrhythmia
Care and treatment
Case Report
Case Reports
Catheters
Electrocardiography
leadless pacemaker
Patients
rate adaptation
sick sinus syndrome
Tachycardia
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Summary:Atrioventricular nodal (AVN) ablation and right ventricular (RV) pacing is recommended for refractory atrial fibrillation (AF) and tachycardia‐bradycardia syndrome. Three AF patients (mean age 83, range 79‐89 years) underwent AVN ablation and transvenous leadless pacemaker Micra™ implantations using the same venous access without anticoagulation interruption. Satisfactory pacing 0.59 (0.50‐0.63) V at 0.24 ms and sensing 11.2 (6.3‐15.6) mV were achieved within 1‐3 deployments. There were no vascular complications nor device dislodgment. Durable pacemaker parameters and VVIR pacing were achieved. Combined AVN ablation and leadless pacemaker implantation is feasible and safe, and avoids pacemaker pocket hematoma and bleeding complications in patients on uninterrupted anticoagulation.
ISSN:1880-4276
1883-2148
DOI:10.1002/joa3.12129