Reddy VY, Neuzil P, Booth DF, Knops RE, Doshi RN, Rashtian M, Exner DV, Banker RS, Nair D, Hadadi CA, Badie N, Yang W, Ligon D, Ip JE. Dual-Chamber Leadless Pacing: Atrioventricular Synchrony in Preclinical Models of Normal or Blocked Atrioventricular Conduction.
Heart Rhythm 2023:S1547-5271(23)02104-5. [PMID:
37075958 DOI:
10.1016/j.hrthm.2023.04.005]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND
Dual-chamber leadless pacemakers (LP) require robust communication between distinct right atrial (RA) and right ventricular (RV) LPs to achieve atrioventricular (AV) synchrony.
OBJECTIVE
This preclinical study evaluated a novel, continuous implant-to-implant (i2i™) communication methodology for maintaining AV-synchronous, dual-chamber DDD(R) pacing by the 2 LPs.
METHODS
RA and RV LPs were implanted and paired in 7 ovine subjects, 4 of 7 with induced complete heart block. AV synchrony (% AV intervals <300 ms) and i2i communication success (% successful i2i transmissions between LPs) were evaluated acutely and chronically. During acute testing, 12-lead ECG and LP diagnostic data were collected from 5-minute recordings, in 4 postures and 2 rhythms (AP-VP and AS-VP or AP-VS and AS-VS) per subject. Chronic i2i performance was evaluated through 23 weeks post-implant (final i2i evaluation period: week 16-23).
RESULTS
Acute AV synchrony and i2i communication success across multiple postures and rhythms were 100.0% [100.0-100.0] (median [interquartile range]) and 99.9% [99.9-99.9], respectively. AV synchrony and i2i success rates did not differ across postures (P=0.59, P=0.11) or rhythms (P=1.00, P=0.82). During the final i2i evaluation period, the overall i2i success was 98.9% [98.1-99.0].
CONCLUSION
Successful AV-synchronous, dual-chamber DDD(R) leadless pacing using a novel, continuous, wireless communication modality was demonstrated across variations in posture and rhythm in a preclinical model.
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