Strazzanti Mattia, Maffeis Caterina, Tomasi Luca, Capocci Sofia, Bolzan Bruna, Franchi Elena, Ribichini Flavio Luciano, Mugnai Giacomo
Cardiology Division, Department of Cardiac, Thoracic and Vascular Sciences, Carlo Poma Hospital, Mantua, Italy.
Cardiology Division, Department of Medicine, School of Medicine, University of Verona, Verona, Italy.
J Cardiovasc Electrophysiol. 2025 May;36(5):1064-1067. doi: 10.1111/jce.16613. Epub 2025 Mar 10.
Leadless pacemakers as the Medtronic Micra AV, have improved cardiac pacing by reducing complications associated with traditional systems. However, achieving high atrioventricular synchrony (AVS) remains a challenge, especially in patients with a high pacing burden. This prospective study enrolled 30 patients to assess the role of echocardiographic parameters in predicting AVS postimplantation. AVS was evaluated via 24-h Holter monitoring, with a median AVS of 67.9% ± 9.6%. Right atrial function, particularly the tricuspidal E wave deceleration time, emerged as the only independent predictor of AVS (p = 0.03), with an AUC of 0.77. These findings suggest that pre-implantation echocardiographic assessment of right atrial parameters could aid in selecting patients who would benefit most from Micra AV. Further studies with larger cohorts and extended follow-ups are warranted.
像美敦力Micra AV这样的无导线起搏器，通过减少与传统系统相关的并发症，改善了心脏起搏。然而，实现高度房室同步（AVS）仍然是一项挑战，尤其是在起搏负担较高的患者中。这项前瞻性研究纳入了30名患者，以评估超声心动图参数在预测植入后AVS中的作用。通过24小时动态心电图监测评估AVS，AVS的中位数为67.9%±9.6%。右心房功能，特别是三尖瓣E波减速时间，成为AVS的唯一独立预测因子（p = 0.03），曲线下面积为0.77。这些发现表明，植入前对右心房参数进行超声心动图评估，可能有助于选择最能从Micra AV中获益的患者。有必要进行更大样本量队列和更长随访时间的进一步研究。
