Cardiology Unit, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy.
Pacing Clin Electrophysiol. 2021 Oct;44(10):1738-1742. doi: 10.1111/pace.14352. Epub 2021 Sep 12.
Leadless pacemakers have become a major breakthrough in the management of bradyarrhythmia as an attractive alternative to the standard transvenous pacemakers, but safety and long-term outcomes of the new Micra-AV, which is capable guarantee atrioventricular (AV) synchrony, have been poorly described. Hence, we describe how we managed a 57-year-old patient who developed pacemaker syndrome due to significant Micra-AV dyssynchrony. This case emphasizes how leadless pacemaker AV synchrony could be overestimated, thereby requiring a stepwise process leading to adequate device reprogramming. Holter-ECG monitoring and exercise test resulted to be valuable tools for an early detection of inadequate AV synchrony, integrating and completing device reports.
无导线起搏器已成为治疗缓律失常的重大突破，作为传统经静脉起搏器的一种有吸引力的替代方案，但新的 Micra-AV （能够保证房室（AV）同步）的安全性和长期结果描述甚少。因此，我们描述了如何处理一位 57 岁患者，该患者因明显的 Micra-AV 不同步而出现起搏器综合征。该病例强调了无导线起搏器 AV 同步性可能被高估，从而需要逐步进行适当的设备重新编程。动态心电图监测和运动试验是早期发现 AV 同步不足的有价值的工具，可整合并完善设备报告。
