Atrial leadless pacemaker implant using Aveir VR in an adolescent with congenital heart disease.

Abstract

Introduction: Pediatric patients with congenital heart disease repair may develop sinus node dysfunction. Leadless pacemakers have provided an alternative option to transvenous and epicardial device implants for pediatric patients in need of ventricular pacing. We describe the first adolescent patient to receive a leadless pacemaker in the atrium due to symptomatic sinus pauses.

Methods: The study was approved by the internal review board of the University of California at Davis. Femoral vein implant was performed of an Aveir VR due to the higher impedance and larger battery capacity.

Results: The 16-year-old male with dextro-transposition of the great arteries and ventricular septal defect repair had an uncomplicated atrial appendage implant of an Atrial Aveir VR, under transesophageal echocardiographic guidance. Three-month follow-up demonstrated stable threshold of 0.5 V @ 0.2 milliseconds, impedance of 720 Ω and sensing of 9.1 mV, with 10 % pacing and predicted battery longevity of 22.8 years.

Conclusion: Atrial implant of a leadless pacemaker is possible in the older pediatric population without complications, including of the Aveir VR.