Leadless Pacing and Cardioversion: Power On or Power Off?
Roland Tilz1, Julius Nikorowitsch1, Anna Traub2
1Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Lübeck, Germany.
Background:
Atrial leadless pacemakers have recently been introduced as an alternative to conventional systems.
Case Summary:
An 86-year-old patient with sinus node dysfunction received a leadless atrial pacemaker. After cardioversion for persistent atrial fibrillation, device interrogation indicated an unexpectedly short battery longevity of only 9 months, despite minimal pacing. Repeat interrogation after 7 days demonstrated recovery of battery life to 6.1 years, suggesting a transient miscalculation.
Discussion:
This case demonstrates that electromagnetic interference from electrical cardioversion can induce a power-on reset (PoR) mode in the Aveir AR pacemaker (Abbott), accompanied by a reset alert. Although PoR briefly interrupts device function, the system resumes normal operation within seconds, retaining programmed settings without reverting to safety mode or requiring reprogramming. Such transient resets may cause false estimates of battery depletion but do not reflect true malfunction.
Take-Home Messages:
PoR after cardioversion can transiently alter battery readings, but settings recover automatically. Recognizing PoR helps avoid misinterpretation and unnecessary interventions.
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