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Multicenter Study
. 2025 Apr;22(4):1010-1020.
doi: 10.1016/j.hrthm.2024.10.020. Epub 2024 Oct 19.

Chronic wireless communication between dual-chamber leadless pacemaker devices

Rahul N Doshi  1 , James E Ip  2 , Pascal Defaye  3 , Derek V Exner  4 , Vivek Y Reddy  5 , Gerhard Hindricks  6 , Robert Canby  7 , Morio Shoda  8 , Maria G Bongiorni  9 , Petr Neužil  10 , Thomas Callahan  11 , Nima Badie  12 , David Ligon  12 , Reinoud E Knops  13
Affiliations
Free article
Multicenter Study

Chronic wireless communication between dual-chamber leadless pacemaker devices

Rahul N Doshi et al. Heart Rhythm. 2025 Apr.
Free article

Abstract

Background: Aveir DR (Abbott, Abbott Park, IL) is a dual-chamber leadless pacemaker (LP) system with distinct atrial and ventricular LPs (ALP, VLP) that communicate wirelessly to deliver atrioventricular synchronous pacing. Success rates of these implant-to-implant (i2i) transmissions have not been systematically evaluated.

Objective: This study aims to evaluate chronic i2i success rates in a clinical setting.

Methods: Patients meeting standard dual-chamber pacing indications were enrolled and implanted with dual-chamber LP systems as part of a prospective international clinical trial (Aveir DR i2i Study). The percent of successful i2i transmissions from ALP-to-VLP (A-to-V) and VLP-to-ALP (V-to-A) were interrogated from LPs in de novo patients using the device programmer at implant, discharge, and at 1, 3, and 6 months postimplant (1M, 3M, 6M).

Results: A total of 399 patients completed device implant and i2i diagnostic interrogation (62% male; age 69 years; 65% sinus node dysfunction, 32% atrioventricular [AV] block). Median A-to-V and V-to-A i2i success rates exceeded 90% of beats at all time-points from implant to 6M. The minority of patients with A-to-V or V-to-A i2i success in <70% of beats at implant (A-to-V: 19% of patients, V-to-A: 31% of patients) showed roughly 40% improvement by 1M, with this minority dropping to roughly 5% of patients by 6M. Improvement in i2i communication success may be attributed to reprogramming of i2i setting levels, natural changes in dominant posture, and device stabilization.

Conclusion: Wireless implant-to-implant communication in the new dual-chamber leadless pacemaker system demonstrated successful transmissions in >90% of beats throughout the 6-month evaluation period. Communication success improved significantly over time postimplant for specific subgroups.

Clinical trial registration: Aveir DR i2i Study, ClinicalTrials.gov ID NCT05252702.

Keywords: Aveir; Dual-chamber; Implant-to-implant communication; Leadless pacemaker; i2i.

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Conflict of interest statement

Disclosures Dr Doshihas has received consulting fees from Abbott and serves as a steering committee member for Abbott. Dr Ip has received consulting fees from Abbott and Medtronic, serves as a steering committee member of Abbott, and is a data safety monitoring committee member of Boston Scientific. Dr Defaye has received research grants from Abbott, Boston Scientific, and Medtronic. Dr Exner has received consulting fees and research grants from Abbott and Medtronic, and—unrelated to this manuscript—has received consulting fees and research grants from Boston Scientific and GE Healthcare as well equity in CorVista, Clarius, eMurmur, HelpWear, and ProtonIntel. Dr Reddy is a consultant to Abbott and—unrelated to this manuscript—he serves as a consultant, for and has equity in, Ablacon, Acutus Medical, Affera-Medtronic, Apama Medical-Boston Scientific, Anumana, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, Laminar, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, Valcare; unrelated to this work, he has served as a consultant for AtriAN, Biosense Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, and Pulse Biosciences and has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. Dr Hindricks serves as a steering committee member for Abbott. Dr Canby has received consulting fees from Medtronic. Dr Shode serves as a steering committee member for Abbott. Dr Bongiorni serves as a steering committee member for Abbott. Dr Callahan has received consulting fees and honoraria from Abbott. Dr Badie and Dr Ligon are employees of Abbott and contributed to preparing and reviewing the manuscript for technical accuracy. Dr Knops has received research grants, consulting fees, and serves as a steering committee member of Abbott and Boston Scientific and has received speaking fees from Medtronic. The remaining author has no conflicts of interest to disclose.

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