Publication Date
3-12-2025
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-24-8495
PMID
40104584
Publication Date(s)
2025
Language
English
PMCID
PMC11914892
PubMedCentral® Posted Date
3-12-2025
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Humans, Male, Cardiac Pacing, Artificial, Aged, Female, Pacemaker, Artificial, Electrophysiologic Techniques, Cardiac, Middle Aged, Sick Sinus Syndrome, Heart Atria, Equipment Design, Heart Rate, Electrocardiography, Atrioventricular Node. Electrophysiologic techniques, cardiac; cardiac pacing, artificial; bradycardia; sick sinus syndrome
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Abstract
The AVEIR DR (Abbott Medical) was the first dual-chamber leadless pacing system approved by the US Food and Drug Administration. Many patients with sinus node dysfunction have physiologically normal atrioventricular conduction, so an atrial-only pacing system may be appropriate for them. Three patients with symptomatic sinus node dysfunction underwent device implantation with electrophysiologic study, including incremental atrial pacing until loss of 1:1 atrioventricular conduction (atrioventricular Wenckebach cycle length) and His-ventricular interval measurement. If the atrioventricular Wenckebach cycle length was no more than 400 milliseconds and the His-ventricular interval measurement was no more than 55 milliseconds, single-chamber atrial implantation was deemed appropriate. Each patient displayed a different response to atrioventricular conduction testing, demonstrating how electrophysiologic study before device implantation may identify patients for whom atrial-only pacing is not appropriate.