Atrial Leadless Pacemaker to Replace Atrial Pacing From a Failed Conventional Transvenous Atrial Lead
Ghazaleh Goldar1, Edward M Powers1
1Division of Cardiovascular Diseases, University of Iowa, Iowa City, Iowa, USA.
Background:
Leadless atrial pacing provides a novel solution for patients with atrial lead failure where extraction is not feasible. The integration of leadless systems with existing cardiac devices offers a promising approach for managing patients in whom lead extraction is considered too risky.
Case Summary:
A 73-year-old man with heart block, after having undergone cardiac resynchronization therapy pacemaker implantation 10 years ago, presented with atrial lead failure. Owing to recent double-lung transplantation and high surgical risk, lead extraction was avoided. A leadless atrial pacemaker was successfully implanted, restoring atrioventricular synchrony by using the atrial sensing from the existing right atrial lead.
Discussion:
This case demonstrates the integration of conventional right atrial lead sensing with leadless pacing technology, offering a safe and effective alternative when lead extraction is too risky.
Take-Home Message:
Leadless atrial pacing integrated with existing cardiac device leads offers a safe and effective alternative for restoring atrioventricular synchrony in high-risk patients in whom lead extraction or revision is not feasible.
