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Case Reports
. 2024 Jan 18;10(4):255-258.
doi: 10.1016/j.hrcr.2024.01.004. eCollection 2024 Apr.

AV conduction mode switch in a leadless pacemaker potentially contributing to ventricular fibrillation

Xiang Wen Lee  1   2 , Ehsan Mahmoodi  1 , Haris M Haqqani  1   2 , Russell A Denman  1
Affiliations
Case Reports

AV conduction mode switch in a leadless pacemaker potentially contributing to ventricular fibrillation

Xiang Wen Lee et al. HeartRhythm Case Rep. .
No abstract available

Keywords: AV Conduction Mode Switch; Atrial sensing; Leadless pacemaker; Micra AV; Ventricular fibrillation.

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Conflict of interest statement

Dr Denman is a principal investigator of clinical trials and advisory board member with Medtronic. Dr Haqqani has received speaking honoraria, consulting, and proctoring fees from Medtronic, Boston Scientific, and Abbott. The other authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
A 12-lead electrocardiogram recorded after presentation with ventricular fibrillation arrest. The patient is in a ventricular-paced rhythm at the programmed rate of 70 beats/min. After correcting for the QRS width and ventricular rate, the corrected QT interval is 442 ms.
Figure 2
Figure 2
Data obtained from inpatient cardiac monitoring with a leadless pacemaker in situ programmed VDD 70. A: The heart rate trend shows an approximately 3-hour period with a heart rate of 45 beats/min. B: The electrocardiogram shows that pacing is not being delivered during this period, followed by pacing recommencing at the programmed rate of 70 beats/min.
Figure 3
Figure 3
Interrogation of the Micra AV device (Medtronic, Minneapolis, MN) following the ventricular fibrillation arrest. A: Electrograms during the periods with a ventricular rate below the programmed lower limit show ventricular sensed events only. B: Rate histograms show that significant periods of time occur with ventricular sensing only without pacing between 40–60 beats/min, which is below the programmed pacing rate. This is consistent with behavior during activation of the AV Conduction Mode Switch algorithm.
See this image and copyright information in PMC

References

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