부산대학교 도서관

Background: The new Aveir VR (Abbott Medical, CA) active-fixation leadless pacemaker (LP) is the second LP system to become available in the United States after the Micra (Medtronic, MN) and offers design improvements over its predecessor, the Nanostim. 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.Method: We describe characteristics and outcomes of patients who underwent implantation with the single chamber Aveir VR between May 2022 and June 2023. Data was collected from electronic medical records, and procedural logs. Variables collected included demographics (eg age, sex, race), procedural characteristics (e.g., procedure length, fluoroscopic duration), hospital length of stay and time to discharge, pacing parameters and complications.Results: A total of 88 patients underwent implantation with the single chamber Aveir VR. The most common indications were symptomatic bradycardia due to sinus node dysfunction (50%), atrioventricular block (34%), and atrial fibrillation with bradycardia (12.5%). Average age was 73.4 years, 52.3% were male, and 53.4% were African Americans. The median procedure duration was 83 minutes (range 36 - 298) and median fluoroscopy time was 10.3 minutes (range 1.4-41.6). Procedure duration improved from a median of 97.5 minutes in the first 10 cases to a median time of 64.5 minutes in the last 10 cases. The average number of mapping locations was 1.7, implant location was RV Apical Septum in 92% of patients, and 0.1% of patients required repositioning. The average R wave amplitude at implant was 7.3 mV (range 2.5-18 mV), average impedance was 763 Ω (range 310-1800), and average pacing threshold was 0.99V (range 0.25-4.5) at 0.4ms. There were no periprocedural complications with any of the implantations. The median hospital length of stay was 5.75 days (range 0.25-77.5), with median time from implant to discharge in elective patients of 50.5 hours.Conclusion: Our experience demonstrates that implantation of the single chamber Aveir VR LP to be safe and effective, comparable to trial data.