Pediatric cardiologists have successfully placed a dual chamber leadless pacemaker in a young patient.
Dan Cortez, the UC Davis Director of Pediatric Electrophysiology, has achieved a remarkable milestone by being the first to implant a dual chamber leadless pacemaker in a child. This significant case report was published recently in the journal PACE: Pacing and Clinical Electrophysiology.
A 13-year-old was referred to the UC Davis pediatric electrophysiology clinic after experiencing presyncope, which involves sensations of lightheadedness or dizziness without fainting, following years of monitoring for congenital complete heart block.
Pacemakers are often used for children with congenital complete heart block, a rare condition that poses risks of sudden death, affecting approximately 1 in every 15,000 to 22,000 children. This condition may arise from previously repaired congenital heart defects or genetic factors. Additionally, it can develop from exposure to certain maternal antibodies.
After various electrocardiograms and Holter monitors indicated a trend of decreasing average heart rates, Cortez discussed the available pacemaker options with the patient and their family.
The dual chamber leadless pacemaker aids in regulating the heart’s rhythm by stimulating both the upper (atrial) and lower (ventricular) chambers. As the patient wished to maintain an active lifestyle in sports, the family opted for the leadless approach.
The AVEIR dual chamber leadless pacemaker was implanted through the patient’s right internal jugular vein (rather than the femoral vein) to facilitate easier movement and a quicker return to sports. This minimally invasive procedure was conducted in the UC Davis Electrophysiology Lab.
The procedure went smoothly, with no complications during or after the implantation. Three months later, the patient was cleared to resume exercise and participate in sports.
The AVEIR device stands out from conventional pacemakers as it lacks leads or wires and is designed to be absorbed by the heart. Additionally, it is ten times smaller than traditional pacemakers. Since gaining FDA approval in 2023, this device has been implanted in adults across the nation.
“Now, everyone, including children, can enjoy the advantages of leadless pacemakers without the long-term complications associated with leads,” said Cortez. “No matter what kind of pacing is necessary—atrial, ventricular, or a combination—kids can safely receive leadless pacing and, following a brief recovery, can engage in unrestricted activities.”
In 2023, Cortez made history as the first doctor globally to implant a retrievable leadless pacemaker in a child. Five years earlier, he was also the first to place a Micra single-chamber leadless pacemaker via the internal jugular vein in a pediatric patient.
