Two Is Better than One: Aveir DR Leadless Pacemaker System with Dual-Chamber Pacing

The Aveir DR dual-chamber Leadless Pacemaker system (Abbott Laboratories) was recently approved by the US Food and Drug Administration and is heralded to be the next generation of leadless pacemakers. Earlier generations of leadless pacemakers could only provide single-chamber right ventricular pacing, limiting their application to a small subset of patients in whom pacemaker therapy is indicated. With the expansion of pacing therapy, the Aveir DR system expands availability of leadless pacing to more patients. Although there have been prior documented experiences with the earlier generation of leadless pacemakers, the addition of a second leadless pacemaker to provide dual-chamber pacing adds new complexities. It is essential to understand what makes the Aveir DR system unique if an anesthesiologist were to come across one perioperatively.