UC Davis Pediatric Electrophysiology Director Dan Cortez has set another world record: He is the first to implant a lead-free dual-chamber pacemaker in a child. His case report was published this week in the journal PACE: Pacing and Clinical Electrophysiology.
A 13-year-old patient was referred to the UC Davis pediatric electrophysiology clinic for presyncope, a feeling of lightheadedness or dizziness without substantial fainting, after years of follow-up for congenital complete heart block.
Pacemakers are usually placed in children with congenital complete heart block, a rare condition that can lead to sudden death and affects about 1 in 15,000 to 22,000 children. Congenital complete heart block can occur due to repaired congenital heart disease or genetic predisposition. It can also be acquired from exposure to certain maternal antibodies.
After serial EKGs and Holter monitors showed progressively lower average heart rates, Cortez talked with the patient and family about pacemaker options.
Dual-chamber leadless pacemakers help regulate the heart’s rhythm by stimulating the upper (atrial) and lower (ventricular) chambers of the heart. Because the patient wanted to remain active in unrestricted sports, lead-free pacing was presented as an option and the family agreed.
The AVEIR dual-chamber leadless pacemaker was implanted through the patient’s right internal jugular vein (instead of the femoral vein) so the patient could move easily and return to sports sooner. The minimally invasive procedure was performed at the UC Davis Electrophysiology Lab.
The patient had no complications during or after the procedure. Three months later, the patient was able to resume exercise and sports.
The AVEIR device differs from traditional pacemakers in part because it has no leads or wires and is absorbed by the heart. It is also 10 times smaller than a traditional pacemaker. This pacemaker has been implanted in adults across the country since receiving FDA approval in 2023.
Everyone, including children, can now have the benefits of lead-free pacemakers and without the long-term complications involved. Regardless of what type of pacing a child needs -?atrial or ventricular, or both-? they can now safely take lead-free pacing and, after the short recovery period, have no restrictions on their activity level.”
Dan Cortez, Director of Pediatric Electrophysiology, UC Davis
In 2023, Cortez was the first doctor in the world to implant a retrievable lead-free pacemaker in a child. Five years before that, Cortez was the first doctor in the world to implant a Micra single-chamber leadless pacemaker through the internal jugular vein in a child.
Source:
Journal Reference:
Cortez, D. (2024). Leadless retrievable Aveir dual-chamber pacemaker implant via the right internal jugular vein in a 13-year-old with congenital complete heart block. Pacing and Clinical Electrophysiology. doi.org/10.1111/pace.15129.
