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Navigating the Lead Paradox: Successful Co-Implantation of Cardiac Contractility Modulation Device and a Micra
Gabriele Pavani1,2,3,4, Paolo Garrone1,3, Gianpaolo Varalda1,3
1Cardiac Electrophysiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
Journal of Cardiovascular Electrophysiology
|January 10, 2026
Summary
This study presents a novel dual-device strategy for managing refractory heart failure in patients with transthyretin cardiac amyloidosis (ATTRwt-CA). Co-implantation of Cardiac Contractility Modulation (CCM) and Micra leadless pacemakers offers a feasible solution to the "lead paradox".
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) frequently leads to refractory heart failure.
- The
- lead paradox
- describes cases where patients with Micra leadless pacemakers need subsequent lead-based Cardiac Contractility Modulation (CCM) therapy.
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