Aveir VR for Atrial Leadless Pacing in Young Patients

Abstract Atrial Leadless pacemaker implantspresent a new treatment for sinus node dysfunction in complex cardiac anatomies. The Aveir-VR single chamber pacemaker can be placed in the atrium to control atrial flutter, or in the ventricle to control bradycardia. In this case report, we present four cases of the implantation of the Aveir VR in the atrium of male pediatric patients to treat sinus node dysfunction. Retrospective review of patients with symptomatic sinus node dysfunction and atrially placed Aveir-VRs was performed at UC Davis between April 2024 and April 2026. Femoral access was the route of implantation for all 5 patients. Trans-esophageal echocardiography was used in all cases. The patients’ ages ranged between 14–17-years and follow-up appointments were held between 1–23-months. Immediately post-procedure, impedances were 380–1460 Ohms, thresholds at 0.4 ms were 2.25–3.5 V, and P-waves were between 1.7–3 mV. Follow-up impedance was between 390–720 Ohms for the patients, thresholds were 0.5–1.25 V at 0.2–0.4 ms, P-waves were between 4.5–9.1 mV, and pacing percentages were between 12–69%. This case series demonstrates the successful implant of Aveir VR leadless pacemaker in five young patients for sinus node dysfunction.