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Related Experiment Video

Updated: Jul 17, 2025

Programmed Electrical Stimulation in Mice

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Published on: May 26, 2010

Acute pacing threshold elevation during simultaneous Micra leadless pacemaker implantation and AV node ablation:

Hugo-Pierre Racine¹, Nicolas Dognin¹, Yanzhu Zhao²

¹Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval (IUCPQ-UL), Quebec, Canada.

Pacing and Clinical Electrophysiology : PACE

|September 4, 2023

Summary

Concurrent AVN ablation with Micra leadless pacing is safe for most patients. Maintaining a safe distance (≥35 mm) and lower power during ablation prevents pacing threshold elevation, a complication in leadless pacemaker procedures.

Keywords:

AV node ablation leadless pacemaker pacing threshold elevation

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Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice

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Published on: June 29, 2022

Area of Science:

Cardiology
Electrophysiology
Medical Devices

Background:

Refractory atrial fibrillation (AF) often necessitates atrioventricular nodal (AVN) ablation and permanent pacemaker implantation.
The Micra Transcatheter Pacing System (Micra) is a leadless pacemaker (LPM) enabling potential AVN ablation during the same procedure.
Pacing threshold (PT) elevation post-radiofrequency (RF) ablation is a known complication.

Purpose of the Study:

To evaluate the safety and potential complications of concurrent AVN ablation with Micra implantation.
To identify factors contributing to pacing threshold elevation after RF AVN ablation in patients with Micra.

Main Methods:

A retrospective cohort study of 84 patients implanted with Micra, including 12 who underwent AVN ablation.
Analysis of procedural characteristics and electrophysiological parameters.
Computer modeling to investigate causes of acute PT elevation.

Main Results:

Two out of 12 patients (16.7%) experienced acute PT elevation requiring Micra retrieval and replacement.
Computer modeling indicated electrical field coupling can cause PT elevation if the ablation catheter is within 35 mm of the Micra at 100 W.
No direct contact between ablation catheter and Micra was observed in the complication cases.

Conclusions:

Concurrent AVN ablation and Micra implantation is generally safe.
A minimum distance of 35 mm between the ablation catheter electrodes and the Micra, along with reduced power settings, can prevent acute PT elevation.