Implanting a Novel Active-Fixation Leadless Pacemaker: A Single Center Experience With the Aveir VR
CIRCULATION(2023)
Abstract
The new Aveir VR (Abbott Medical, CA) active-fixation leadless pacemaker (LP) offers several novel innovations. It uses a unique mapping capability to help reduce repositioning attempts prior to fixation and utilizes a helical fixation mechanism for implantation and chronic retrieval. We describe the current largest real world descriptive single center experience with the new Aveir VR LP. This retrospective study describes the characteristics and outcomes of patients who underwent implantation with the single chamber Aveir LP between May 2022 and December 2022. Data was collected from patients’ electronic medical records, dictation forms and procedural logs. Variables collected included demographics (eg age, sex, race), procedural characteristics (eg procedure length, fluoroscopic duration), hospital length of stay and time to discharge, pacing parameters and complications. A total of 48 patients underwent implantation with the single chamber Aveir LP. The most common indications were symptomatic bradycardia due to sinus node dysfunction (55%) and atrial fibrillation with bradycardia (29%). The average age of patients was 72.5 years, 51% were male, and 53% were African Americans. The average procedure duration was 34.3 minutes (range 15–106) and average fluoroscopy time was 13.4 minutes (range 1.4–41.6). Procedure duration improved from a median of 36.0 minutes in the first 10 cases to a median time of 26.0 minutes in the last 10 cases done by the same operator. The average number of mapping locations was 1.6 prior to fixation, implant location was low septal in 84% of patients, and 8.3% of patients required repositioning. The average R wave amplitude at implant was 8.3 mV (range 3.0–18), average impedance was 789 Ω (range 380–1800), and average pacing threshold was 0.87V (range 0.25–2.5) at 0.4ms. There were no periprocedural complications with any of the implantations. The average hospital length of stay was 13 days (range 0.5–63), however the average time from implant to discharge in patients presenting electively was 15 hours. Our experience demonstrates that implantation of the single chamber Aveir VR LP has been safe and effective and is comparable to trial data.
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Key words
Electrophysiology,Pacemakers,Right Ventricular,Wireless
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