Simultaneous Leadless Pacemaker Implant With Atrioventricular Node Ablation via Internal Jugular Approach
Abstract
INTRODUCTION: The feasibility and outcomes of simultaneous atrioventricular node ablation (AVNA) and leadless pacemaker (LLPM) implantation from the internal jugular (IJ) vein are not well studied. We report our single-center case series experience with concomitant implantation of the AVEIR LLPM and AVNA from the IJ venous approach.
METHODS: Patients with persistent atrial fibrillation (AF) with frequent rapid ventricular rate (RVR) episodes refractory to pharmacological therapy and not ideal for AF ablation were selected for LLPM and AVNA. These procedures were performed simultaneously via the IJ vein due to patient preference and anatomical challenges (presence of severe scar tissue from prior procedures, presence of an inferior vena cava [IVC] filter, etc.). All patients were followed for at least 4 weeks post procedure.
RESULTS: Ten patients (mean age of 76.1 ± 11.5 years, 60% female) underwent successful simultaneous AVEIR implantation and AVNA via IJ venous access. Median device implantation time was 15.5 min, procedure time was 45 min, fluoroscopy time was 6.4 min, and radiation dose was 82 mGy. No device repositioning occurred. Mean pacing capture threshold at implant was 0.65 ± 0.316 V and impedance of 848 ± 209 Ω. At follow-up, pacing capture threshold was 0.5 V at 0.4 ms in all patients. Mean radiofrequency (RF) time to successful AVN ablation was 191.6 ± 86 s. Hemostasis was obtained within 5 min in all cases. There were no procedure-related complications and no…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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