Abstract 16688: Impact on Preoperative Estimation of Atrial Mechanical Amplitudes Before With VDD Leadless Pacemaker

Abstract

Introduction: It would be useful to judge whether the device can sense atrial systole or not before an implantation of a VDD leadless pacemaker (Micra AV RT , Medtronic, US). Hypothesis: Mechanical atrial amplitude for Micra AV RT associated with atrial construction at implantation location. Methods: Echocardiographic measurements were performed to quantify the atrial motion of the interventricular septum in patients who received leadless pacemaker implantation. We visually divided the septum into five segments from the base to the apex. The myocardial velocity of each segment measured on tissue doppler imaging (TDI) was defined as EV1, 2, 3, 4, and EV5 (m/s), respectively. Results: Fourteen patients (79.5 years, 8 males) receiving Micra AV from November 2021 to February 2023 at our institution were analyzed. The average myocardial velocity of atrial contraction at each site tended to decrease as getting closer to apex (EV1:8.9, EV2:8.0, EV3:7.0, EV4:5.8, EV5:3.5 cm/s) as shown in Figure. The implantation location was estimated from fluoroscopy and postoperative echocardiography, and mechanical atrial amplitude (A4) and the local EV were compared; Patients with lower than 2.0 m/s 2 A4 had also lower the local EV than others. (3.6 vs 5.9 m/s, p=0.037). Conclusions: Preprocedural estimation of mechanical atrial amplitude of Micra AV is possible on septal TDI.