UC Davis surgeon develops dual-chamber leadless pacemaker in 13-year-old patient

UC Davis surgeon develops dual-chamber leadless pacemaker in 13-year-old patient

Dan Cortez, director of pediatric electrophysiology at UC Davis, has set another world record: He is the first person to implant a dual-chamber leadless pacemaker in a child. His case report was published in the journal this week PACE: stimulation and clinical electrophysiology.

A 13-year-old patient was referred to the UC Davis Pediatric Electrophysiology Clinic for presyncope, a feeling of lightheadedness or dizziness without actual fainting, after years of being monitored for congenital complete heart block.

Pacemakers are typically used in children with congenital complete heart block, a rare condition that can cause sudden death and affects one in about 15,000 to 22,000 children. Congenital complete heart block can occur due to repaired congenital heart disease or a genetic predisposition. It can also be acquired through exposure to certain maternal antibodies.

After serial electrocardiograms and Holter monitors showed progressively lower average heart rates, Cortez discussed pacemaker options with the patient and his family.

Dual-chamber leadless pacemakers help regulate the heart's rhythm by stimulating the upper (atrium) and lower (ventricular) chambers of the heart. Because the patient wanted to remain physically active without restrictions, leadless stimulation was suggested as an option and the family agreed.

The AVEIR dual-chamber electronic pacemaker was implanted through the patient's right internal jugular vein (instead of the femoral vein) to allow the patient to move more easily and return to exercise more quickly. The minimally invasive procedure took place in the UC Davis Electrophysiology Lab.

The patient had no complications during or after the procedure. Three months later the patient was able to exercise again.

The AVEIR device differs from traditional pacemakers in part because it has no leads or cables and is absorbed by the heart. It is also ten times smaller than a conventional pacemaker. This pacemaker has been implanted in adults across the country since receiving FDA approval in 2023.

Everyone, including children, can now enjoy the benefits of leadless pacemakers and without the long-term complications that come with leads. No matter what type of stimulation a child needs – atrial or ventricular or both – they can now safely receive leadless pacing and have no restrictions on their activity level after the short recovery period.”

Dan Cortez, director of pediatric electrophysiology, UC Davis

In 2023, Cortez became the first doctor in the world to implant a retrievable, leadless pacemaker in a child. Five years earlier, Cortez became the first doctor in the world to implant a Micra single-chamber leadless pacemaker through the internal jugular vein in a child.

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