Leadless Micra Pacemaker Use in the Pediatric Population: Device Implantation and Short-Term Outcomes

Breatnach, Colm R.; Dunne, Lisa; Al-Alawi, Khalid; Oslizlok, Paul; Kenny, Damien; Walsh, Kevin

doi:10.1007/s00246-019-02277-y

Cited by 30 publications

(25 citation statements)

References 18 publications

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“…The largest single-center cohort to date included only nine patients (median age: 13 years, median weight: 37 kg). 4 A conventional femoral venous approach was generally adopted, although all patients were older than 11 years and more than 30 kg in weight. 4 – 6 Alternatively, Gallotti et al and Cortez presented different cases performed using right internal jugular venous access in smaller patients.…”

Section: Discussionmentioning

confidence: 99%

“… 4 A conventional femoral venous approach was generally adopted, although all patients were older than 11 years and more than 30 kg in weight. 4 – 6 Alternatively, Gallotti et al and Cortez presented different cases performed using right internal jugular venous access in smaller patients. 7 , 8 The jugular approach was favored given patient and vessel size considerations as well as the notion of easier device maneuverability across the TV and within the RV from a superior approach.…”

Section: Discussionmentioning

confidence: 99%

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Leadless Pacemaker Implantation in a Four-year-old, 16-kg Child

Mahendran¹,

Bussey²,

Chang³

2020

J Innov Cardiac Rhythm Manage.

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Leadless pacemakers have an accepted role with demonstrable benefits in adults. In contrast, implant experience and follow-up data in pediatric patients are more limited. Clinical indications and patient candidacy for leadless pacing in pediatrics continue to evolve. We present our experience implanting a leadless pacemaker in a four-year-old for the treatment of high-grade atrioventricular block. Implant considerations in small patients, short-term patient and device follow-up data, and follow-up assessment of the vessel used for implantation are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leadless Pacemaker Implantation in a Four-year-old, 16-kg Child

Mahendran¹,

Bussey²,

Chang³

2020

J Innov Cardiac Rhythm Manage.

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“…Breatnach et al reported on the successful implantation of the Micra™ TPS in nine pediatric patients ranging in weight from 31 to 50 kg via the right femoral vein. 5 A limitation to the use of the Micra™ TPS in the pediatric population is the large size of the delivery sheath. Limited case reports have described the placement of the Micra™ TPS via the right internal jugular vein in a patient as small as 18 kg.…”

Section: Introductionmentioning

confidence: 99%

Delivery of a Leadless Transcatheter Pacing System as First-line Therapy in a 28-kg Pediatric Patient Through Proximal Right Internal Jugular Surgical Cutdown

Hackett¹,

Aziz²,

Samii³

et al. 2021

J Innov Cardiac Rhythm Manage.

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The Micra™ transcatheter pacing system (TPS) (Medtronic, Minneapolis, MN, USA) is the only leadless pacemaker currently approved by the United States Food and Drug Administration. A limitation to the use of this device in the pediatric population is the large size of the delivery sheath. We present a 28-kg, nine-year-old male with symptomatic asystolic pauses who underwent successful placement of a Micra™ TPS via right internal jugular vein surgical cutdown as a first-line option. Current reports in the literature using the right internal jugular vein due to small patient size are limited to those involving patients with concurrent medical conditions that render the use of traditional systems unfavorable or contraindicated. Given the potential benefits of a leadless pacemaker system, its use in the pediatric population will likely continue to increase with time. This case describes technical strategies and procedural caveats that could aid in continued successful implantations of the Micra™ TPS in smaller patients as first-line therapy. In this report, room setup, the use of preprocedure vascular duplex studies, sheath manipulation, and a multidisciplinary approach are reviewed.

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“…The smaller ventricular cavity may also pose challenges in maneuvering the device. Breatnach et al reported the largest retrospective case series of nine pediatric patients with a median inter‐quartile range (IQR) age and weight of 13 years (12‐14) and 37 kg (31‐50 kg) managed with TPS implantation, to avoid the complications of a TVPM system, multiple pocket revisions, and battery replacements and to allow continuation of sport activities 31 . In this case series, the Micra leadless system was inserted safely in all patients, following the standard implantation technique via right femoral venous access and delivered to an RV septal or apical position.…”

Section: Introductionmentioning

confidence: 99%

Leadless pacemaker: State of the art and incoming developments to broaden indications

Curnis

Salghetti

Cerini

et al. 2020

Pacing Clinical Electrophis

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Theleadless pacemaker (LLPM) therapy has been developed in recent years to overcome the transvenous lead and device pocket‐related complications. The LLPMs now available are self‐contained right ventricular pacemakers and are limited to single‐chamber ventricular pacing modality. This literature review deals with the current status of LLPM technology and current areas of clinical applicability. The safety and efficacy outcomes published from randomized clinical trials and real world registries are analyzed and compared with historical conventional transvenous pacemaker data. Furthermore, new pacing modalities and future perspectives to broaden the clinical use and cover most of pacing indications are discussed. Due to the overall safe and effective profile in the short term and intermediate term, also in fragile patients, the LLPM use is constantly growing in daily clinical practice. Actually, it can be considered a landmark innovation, through which a new era of cardiac pacing has begun.

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Leadless Micra Pacemaker Use in the Pediatric Population: Device Implantation and Short-Term Outcomes

Cited by 30 publications

References 18 publications

Leadless Pacemaker Implantation in a Four-year-old, 16-kg Child

Leadless Pacemaker Implantation in a Four-year-old, 16-kg Child

Delivery of a Leadless Transcatheter Pacing System as First-line Therapy in a 28-kg Pediatric Patient Through Proximal Right Internal Jugular Surgical Cutdown

Leadless pacemaker: State of the art and incoming developments to broaden indications

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