Behavior of leadless AV synchronous pacing during atrial arrhythmias and stability of the atrial signals over time—Results of the MARVEL Evolve subanalysis.

Introduction: The MARVEL study demonstrated at a single time point that accelerometer (ACC)‐based atrial sensing improves atrioventricular (AV) synchrony (AVS) in patients with AV block and a Micra pacemaker (Medtronic, Minneapolis, MN, USA). The purpose of the MARVEL Evolve substudy was to assess t...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 42; no. 3; pp. 381 - 388
Autores principales: Garweg, Christophe, Splett, Vincent, Sheldon, Todd J., Chinitz, Larry, Ritter, Philippe, Steinwender, Clemens, Lemme, Francesca, Willems, Rik
Formato: research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Behavior of leadless AV synchronous pacing during atrial arrhythmias and stability of the atrial signals over time—Results of the MARVEL Evolve subanalysis.
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          Garweg, Christophe
          Splett, Vincent
          Sheldon, Todd J.
          Chinitz, Larry
          Ritter, Philippe
          Steinwender, Clemens
          Lemme, Francesca
          Willems, Rik
        affil: Department of Cardiovascular Sciences, University of Leuven, Leuven Belgium
      sug:
        subj:
          Heart Block Therapy
          Cardiac Pacing, Artificial
          Accelerometers Evaluation
          Pacemaker, Artificial Evaluation
          Cardiac Resynchronization Therapy
          Prospective Studies
          Male
          Female
          Aged
          Aged, 80 and Over
          Bradycardia
          Office Visits
          Sinoatrial Node Physiology
          Confidence Intervals
          Tachycardia
          Atrial Fibrillation
          Atrial Flutter
          Human
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: The MARVEL study demonstrated at a single time point that accelerometer (ACC)‐based atrial sensing improves atrioventricular (AV) synchrony (AVS) in patients with AV block and a Micra pacemaker (Medtronic, Minneapolis, MN, USA). The purpose of the MARVEL Evolve substudy was to assess the performance over time. Methods: This prospective single‐center study compared AVS and ACC signals at two visits ≥6 months apart. Custom software was temporarily downloaded into the Micra at each visit and AVS was measured during 30 min at rest. Results: Nine patients from the MARVEL study were enrolled. The mean (±standard deviation) age was 82.3 ± 6.0 years old, 67% were male, and a Micra was implanted for 6.0 ± 6.4 months. High‐degree AV block was present in four patients, whereas five with predominantly intrinsic conduction required intermittent pacing for bradycardia. The mean interval between visits was 7.1 ± 0.6 months. Seven patients had normal sinus node function at both visits and were included in a paired analysis. Both ACC signal amplitude (visit 2‐visit 1 = 1.4 mG; 95% confidence interval [CI] [−25.8 to 28.4 mG]; P = 0.933) and AVS (visit 1: 90.8%, 95% CI [72.4, 97.4] and visit 2: 91.4%, 95% CI [63.8, 98.5]; P = 0.740) remained stable. Three patients had spontaneous atrial tachycardia. During atrial fibrillation, no atrial contraction was detected or tracked. During atrial flutter, intermittent tracking resulted in a ventricular rate of 60 ± 8 beats per minute (bpm); there was no ventricular pacing >100 bpm. Conclusion: ACC signals amplitude and performance of AVS pacing were stable over time. During atrial arrhythmias, the AV synchronous pacing mode behaved safely.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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