Correlation between AV synchrony and device collected AM-VP sequence counter in atrioventricular synchronous leadless pacemakers: A real-world assessment.
| dc.contributor.author | Garweg, Christophe | |
| dc.contributor.author | Piccini, Jonathan P | |
| dc.contributor.author | Epstein, Laurence M | |
| dc.contributor.author | Frazier-Mills, Camille | |
| dc.contributor.author | Chinitz, Larry A | |
| dc.contributor.author | Steinwender, Clemens | |
| dc.contributor.author | Stromberg, Kurt | |
| dc.contributor.author | Sheldon, Todd | |
| dc.contributor.author | Fagan, Dedra H | |
| dc.contributor.author | El-Chami, Mikhael F | |
| dc.date.accessioned | 2024-04-04T21:55:34Z | |
| dc.date.available | 2024-04-04T21:55:34Z | |
| dc.date.issued | 2023-01 | |
| dc.description.abstract | IntroductionMicra atrioventricular (AV) provides leadless atrioventricular synchronous pacing by sensing atrial contraction (A4 signal). Real-world operation and reliability of AV synchrony (AVS) assessment using device data have not been described. The purposes of this study were to (1) assess the correlation between AVS and atrial mechanical sensed-ventricular pacing (AM-VP) percentages in patients with permanent high-degree AV block and (2) report on the real-world effectiveness of Micra AV.MethodsThe correlation between ECG-determined AVS in-clinic and device-collected %AM-VP was assessed using data from 40 patients with high-degree AV block enrolled in the Micra Atrial tRacking using a Ventricular AccELerometer (MARVEL) 2 study. A retrospective analysis to assess continuously-sampled %AM-VP since last session, device programming, and electrical parameters was performed using Micra AV transmissions from the Medtronic CareLink database. Patients with transmissions ≥180 days postimplant were included.ResultsAmong the 40 MARVEL 2 AV block patients with a median %VP of 99.7%, AVS was highly correlated with AM-VP (median AVS 87.1%, median AM-VP 79.1%; R2 = 0.764, p < .001). The CareLink cohort included 4384 patients programmed to VDD mode. The mean A4 amplitude was 2.3 ± 1.8 m/s2 at implant and 2.3 ± 1.6 m/s2 at 28 weeks. In patients with %VP >90% (n = 1662), the median %AM-VP was 74.7%. For the full cohort, median %VP was 65.6% and median projected battery longevity was 10.5 years.ConclusionIn patients with a high pacing burden, %AM-VP provides a reasonable estimation of AVS. The first large real-world analysis of Micra AV patients with >90% VP showed stable atrial sensing over time with a median %AM-VP, a correlate of AVS, of 74.7%. | |
| dc.identifier.issn | 1045-3873 | |
| dc.identifier.issn | 1540-8167 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Wiley | |
| dc.relation.ispartof | Journal of cardiovascular electrophysiology | |
| dc.relation.isversionof | 10.1111/jce.15726 | |
| dc.rights.uri | ||
| dc.subject | Humans | |
| dc.subject | Atrial Fibrillation | |
| dc.subject | Cardiac Pacing, Artificial | |
| dc.subject | Retrospective Studies | |
| dc.subject | Reproducibility of Results | |
| dc.subject | Pacemaker, Artificial | |
| dc.subject | Atrioventricular Block | |
| dc.title | Correlation between AV synchrony and device collected AM-VP sequence counter in atrioventricular synchronous leadless pacemakers: A real-world assessment. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Piccini, Jonathan P|0000-0003-0772-2404 | |
| pubs.begin-page | 197 | |
| pubs.end-page | 206 | |
| pubs.issue | 1 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Medicine, Cardiology | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.publication-status | Published | |
| pubs.volume | 34 |
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