549 The role of conventional and speckle tracking echocardiography in the evaluation of leadless endocardial pacing with Micra-AV. (8th December 2021)

• Record Type: Journal Article
• Authors: Soldato, Nicolò; Bozza, Nicola; Basile, Paolo; Pontone, Gianluca; Siena, Paola; Memeo, Riccardo; Santobuono, Vincenzo Ezio; Carella, Maria Cristina; Favale, Stefano; Guaricci, Andrea Igoren
• Is Part Of: European heart journal supplements. Volume 23(2021)Supplement G
• Publication Date: 2021-12-08
• Subjects: Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suab127.043
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Aims: Micra-AV pacing system is a leadless pacemaker (LP) implanted in the right ventricle which can provide atrio-ventricular (AV) synchronous pacing. Echocardiographic data assessing left ventricle contractility 24–48 h after Micra AV implantation are lacking. To evaluate via conventional echocardiography and speckle-tracking echocardiography (STE), which was the best pacing modality (VVI vs. VDD) able to ensure the most efficient hemodynamic performance assessed by left ventricle ejection fraction (LF-EF) and global longitudinal strain (GLS). Methods and results: We studied nine patients with high degree AV-block, enrolled in our Institution in a range of time of 5 months. All patients had first degree AV block (PQ interval between 160 and 340 ms). They were considered suitable candidates for MICRA-AV implantation according to current guidelines. Both LF-EF and GLS were performed 24–48 h after device implantation by two experienced echocardiographic physicians. The mean age of the population was 79 ± 8 years (8 were male, 89%). Risk factors more represented were hypertension and dyslipidaemia. The maximum PQ interval was 256 ± 51 ms. VDD pacing modality allows better LV-EF values than those obtained with a VVI stimulation (with a difference that was statistically significant difference, P -value = 0.008). Similarly, we obtained better GLS values during VDD pacing as respect to VVI ( P -value = 0.008). Conclusions: Left ventricle ejection fraction and LV-GLS improve early after leadless MICRA-AV implantation during VDD as compared to VVI pacing modality.