Abbott Avenir Atrial Leadless Pacemaker Implantation—dislodgement

Hi everyone, 

I had an Abbott Avenir Leadless pacemaker installed last week due to Sick Sinus Syndrome.  I chose that type over the leaded option due to the easier implantation and recovery time. The implantation went well--took less than 2 hours--but then became dislodged and moved to my pulmonary artery where, thank God, it was retrieved without issue.  So, I still have to get my SSS resolved but am hoping I can get more information to help determine my course of action. I did have a looping device installed to track my heart rate and am hoping I can sit tight and not have to get this resolved quickly. 

My issues have been intermittent for several years although my heart rate has gone low and with pauses more often recently. I'm  in good shape, exercise daily so I'm trying to figure out why it dislodged--surgeon issue? Heart wall issue? Other?

Has anyone else used the Abbott Avenir atrial product and, if so, what is your experience?  I still believe it is great technology although it is fairly new (FDA approved last July).  I'd also love to hear from other anyone else with a leadless pacemaker and learn of your experience to determine if I should stick with the leadless or go with the leaded.  I appreciate any comments in advance.

Thank you, 

 

3 Comments

A difficult decision to make depending on your lifestyle

by Gemita - 2024-05-07 04:27:02

KFOCO, firstly, I am so sorry to hear about the dislodgement of your Abbott Aveir Atrial leadless pacemaker last week.  That must have been so worrying but I am glad it was successfully retrieved before it did any damage.  I note leadless pacemakers carry a small risk of dislodgement and embolization into the pulmonary arteries.  Why did it happen?  A question for your team.  Even with a conventional pacemaker system with leads, leads can dislodge too within the first weeks of pacemaker implantation when the actual cause for dislodgement can be difficult to trace.

I can see the benefits of the leadless pacemaker too and I am sure leadless cardiac devices will see significant growth and development over the coming years.  However, although there are many benefits of leadless pacing, largely due to the elimination of pocket-related complications, I am still unclear whether it can match the conventional lead pacemaker with its many algorithms and ability to give active patients an excellent level of exercise control at high heart rates?  Also more evidence on device management at end of battery life and extraction will be needed too for leadless pacing to be truly considered a viable first-line therapy option.

I see you now have an implantable loop recorder that continuously checks your heart rhythm for several years.  This will be very helpful and give immediate warning of any siginificant pausing or high heart rates that may need treating.  This means it can find small changes in your heart rhythm that other tests may have missed.  I had a Medtronic Reveal Linq loop recorder implanted in 2016 and I kept it implanted for 3+ years, even after my dual lead pacemaker was implanted in 2018 since my doctor said it had superior ability to monitor, store and record rhythm disturbances. 

Although the majority of members here have pacemakers with leads, we have several members now with leadless pacemakers, some with dual leadless pacemakers, and if you search Leadless, see top right under Q, you will find several posts.  

I hope you stay safe and that your doctors monitor you closely and step in quickly should you require pacemaker support.  Good luck and welcome

Sorry to hear

by Penguin - 2024-05-07 04:38:54

I can't add anything to Gemita's comment above, but wanted to pass on my best wishes to you after that baptism of fire!  The implantable loop recorder will hopefully show your doctors what's going on with your heart rhythm very clearly. Perhaps this will prove to be the silver lining and will help them identify pacing algorithms that will help you best.  This may aid device selection. 

Keep us informed! 

Best Wishes

leadless

by Tracey_E - 2024-05-07 09:45:16

We have a very few members with leadless, you are the first I've seen who tried aveir. This is the one my doctor is considering for me later this year so I've been avidly watching for any reports. 

I don't know how the leadless differs from traditional leads when the they come dislodged, but traditional leads usually come dislodged because the heart wall didn't like it or it wasn't in a good spot, or just bad luck, much less often because of something we've done. 

I'm so glad they were able to retrieve it easily! Good luck deciding what to try next. Is there a reason they didn't try to place it again when they retrieved it?

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