Atrial leadless pacing for heart failure in sick sinus syndrome
- 1Department of Cardiology, Tokyo Medical University, Tokyo, Japan
Abstract
Two patients with sick sinus syndrome and heart failure were treated with atrial leadless pacing. Case 1 demonstrated hemodynamic improvement with cardiac output increase (3.0 → 5.1 L/min), B-type natriuretic peptide (BNP) reduction (3223 → 480 pg/mL), and New York Heart Association class improvement (III → I) following Aveir dual-chamber leadless pacemaker (Abbott Medical, Inc., Plymouth, MN, USA) implantation. Case 2, at high infection risk with mechanical valve and prior endocarditis, received hybrid therapy combining atrial fibrillation ablation, Aveir atrial pacing, and subcutaneous implantable cardioverter-defibrillator implantation, achieving left ventricular ejection fraction improvement (20 → 38%) and BNP reduction (321 → 28 pg/mL). Atrial leadless pacing may represent a therapeutic option in selected patients with preserved atrioventricular conduction or high infection risk requiring physiologic pacing.
Learning objective: This case report demonstrates that atrial leadless pacing can be an effective treatment option for patients with sick sinus syndrome complicated by heart failure when conventional transvenous atrial pacing is undesirable. In one of the presented cases, the feasibility of combining a leadless pacemaker with a subcutaneous implantable cardioverter-defibrillator is also illustrated, providing insight into a potential lead-free device strategy.
Related
- Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model
- Congenital sinus node dysfunction and atrial fibrillation in pediatric short QT syndrome type 2: Implications for pacing strategy.
- Accelerated pacing rates to improve exercise tolerance, quality of life, and arrhythmia burden in patients with evidence of heart failure with preserved ejection fraction: The PACE-UP rationale and design
- Failure of Implantable Cardioverter-defibrillator Pacing Capture in BRASH Syndrome with Severe Hyperkalemia.
- Combined impact of paced QRS duration and right ventricular pacing burden on heart failure admission: Identifying clinical progression to stage C/D in pacemaker recipients.
BibTeX
@article{sato2026atrial,
title = {{Atrial leadless pacing for heart failure in sick sinus syndrome}},
author = {Shinnosuke Sato and Yasuyuki Takada and Junichi Kamoshida and Muryo Terasawa and Kazuhiro Satomi and Yoshinao Yazaki},
journal = {Journal of Cardiology Cases},
year = {2026},
month = aug,
doi = {10.1016/j.jccase.2026.07.007},
url = {https://doi.org/10.1016/j.jccase.2026.07.007},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Atrial leadless pacing for heart failure in sick sinus syndrome
AU - Shinnosuke Sato
AU - Yasuyuki Takada
AU - Junichi Kamoshida
AU - Muryo Terasawa
AU - Kazuhiro Satomi
AU - Yoshinao Yazaki
PY - 2026
DA - 2026/08/08
JO - Journal of Cardiology Cases
DO - 10.1016/j.jccase.2026.07.007
UR - https://doi.org/10.1016/j.jccase.2026.07.007
AB - Two patients with sick sinus syndrome and heart failure were treated with atrial leadless pacing. Case 1 demonstrated hemodynamic improvement with cardiac output increase (3.0 → 5.1 L/min), B-type natriuretic peptide (BNP) reduction (3223 → 480 pg/mL), and New York Heart Association class improvement (III → I) following Aveir dual-chamber leadless pacemaker (Abbott Medical, Inc., Plymouth, MN, USA) implantation. Case 2, at high infection risk with mechanical valve and prior endocarditis, received hybrid therapy combining atrial fibrillation ablation, Aveir atrial pacing, and subcutaneous implantable cardioverter-defibrillator implantation, achieving left ventricular ejection fraction improvement (20 → 38%) and BNP reduction (321 → 28 pg/mL). Atrial leadless pacing may represent a therapeutic option in selected patients with preserved atrioventricular conduction or high infection risk requiring physiologic pacing. Learning objective: This case report demonstrates that atrial leadless pacing can be an effective treatment option for patients with sick sinus syndrome complicated by heart failure when conventional transvenous atrial pacing is undesirable. In one of the presented cases, the feasibility of combining a leadless pacemaker with a subcutaneous implantable cardioverter-defibrillator is also illustrated, providing insight into a potential lead-free device strategy.
SN - 1878-5409
ER -