Aveir VR real-world performance and chronic pacing threshold prediction using mapping and fixation electrical data.
Europace
; 26(3)2024 Mar 01.
Article
in En
| MEDLINE
| ID: mdl-38457487
ABSTRACT
AIMS:
Aveir VR performance and predictors for its pacing threshold (PCT) in a real-world cohort were investigated.METHODS:
Electrical measurements at various stages of an Aveir VR implant were prospectively collected. Predictors for 3-month PCT were studied. A retrospective cohort of consecutive 139 Micra implants was used to compare the PCT evolution. High PCT was defined as ≥1.5â V, using a pulse width of 0.4â ms for Aveir and 0.24â ms for Micra. Excellent PCT was defined as ≤0.5â V at the respective pulse width.RESULTS:
Among the 123 consecutive Aveir VR implant attempts, 122 (99.2%) were successful. The majority were of advanced age (mean 79.7) and small body size (mean BSA 1.60). Two patients (1.6%) experienced complications, including one pericardial effusion after device reposition and one intraoperative device dislodgement. Eighty-eight patients reached a 3-month follow-up. Aveir 3-month PCT was correlated with impedance at mapping (P = 0.015), tether mode (P < 0.001), end-of-procedure (P < 0.001), and mapping PCT (P = 0.035), but not with PCTs after fixation (P > 0.05). Tether mode impedance >470â ohms had 88% sensitivity and 71% specificity in predicting excellent 3-month PCT. Although it is more common for Aveir to have high PCT at end of procedure (11.5% for Aveir and 2.2% for Micra, P = 0.004), the rate at 3â months was similar (2.3% for Aveir and 3.1% for Micra, P = 1.000).CONCLUSION:
Aveir VR demonstrated satisfactory performance in this high-risk cohort. Pacing thresholds tend to improve to a greater extent than Micra after implantation. The PCT after fixation, even after a waiting period, has limited predictive value for the chronic threshold. Low-mapping PCT and high intraoperative impedance predict chronic low PCT.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pacemaker, Artificial
/
Virtual Reality
Limits:
Humans
Language:
En
Journal:
Europace
Journal subject:
CARDIOLOGIA
/
FISIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: