Right Ventricular Anatomy Can Accommodate Multiple Micra Transcatheter Pacemakers

Area of Science:

• Cardiology
• Medical Devices
• Anatomical Studies

Background:

• Transcatheter pacemaker technology offers an alternative to traditional leaded systems, potentially reducing complications.
• New questions arise regarding device management, RV accommodation, and patient suitability for leadless pacing.
• This study investigates the feasibility of implanting multiple leadless pacemaker devices in human hearts.

Purpose of the Study:

• To assess the anatomical feasibility of implanting multiple transcatheter pacemaker devices within the right ventricle.
• To determine the number of devices that can be accommodated in traditional pacing locations.
• To evaluate device placement and spacing without physical interaction.

Main Methods:

• Six human cadaver hearts and one reanimated human heart were used.
• Multiple Micra devices were implanted in traditional right ventricular pacing locations using fluoroscopic imaging.
• Right ventricular volumes were measured, and hearts were dissected to examine device placement and spacing.

Main Results:

• Multiple Micra devices were successfully implanted in each heart within accepted pacing locations.
• No physical device interactions were observed, even in a smaller-than-average heart.
• The right ventricle demonstrated capacity for accommodating three or more leadless pacemaker devices.

Conclusions:

• The human right ventricle can accommodate at least three transcatheter pacemaker devices in standard pacing locations.
• This study supports the potential for using multiple leadless pacemakers, addressing accommodation concerns.
• Further research may explore the possibility of implanting even more devices in certain anatomies.