UC Davis Director of Pediatric Electrophysiology Dan Cortez has made medical history once again by becoming the first to implant a dual chamber leadless pacemaker in a child. This achievement is detailed in his case report, which was recently published in the journal PACE: Pacing and Clinical Electrophysiology. The patient, a 13-year-old with congenital complete heart block, was experiencing presyncope, a sensation of lightheadedness, prompting a referral to the UC Davis pediatric electrophysiology clinic.
Congenital complete heart block is a rare condition that affects around 1 in 15,000 to 22,000 children and can lead to sudden death if left untreated. This condition can be caused by repaired congenital heart disease, genetic predisposition, or exposure to maternal antibodies. In this case, the patient had been monitored for years and was experiencing progressively lower average heart rates, necessitating the discussion of pacemaker options between Cortez, the patient, and their family.
Dual chamber leadless pacemakers are designed to regulate the heart’s rhythm by stimulating both the upper (atrial) and lower (ventricular) chambers of the heart. Given the patient’s desire to remain active in sports without restrictions, leadless pacing was presented as a viable option, which the family ultimately agreed to. The AVEIR dual chamber leadless pacemaker was implanted through the patient’s right internal jugular vein in a minimally invasive procedure at the UC Davis Electrophysiology Lab, allowing for easier movement and quicker return to sports activities.
Following the implantation of the AVEIR pacemaker, the patient experienced no complications during or after the procedure. Three months later, the patient was able to resume exercise and play sports, highlighting the success of the leadless pacing technology. The AVEIR device differs from traditional pacemakers as it does not have any leads or cords and is absorbed by the heart, providing a more efficient and less invasive option for patients.
Cortez emphasizes the significance of leadless pacing technology, noting that it allows individuals, including children, to benefit from pacemakers without the complications associated with leads in the long term. With the ability to deliver atrial, ventricular, or dual chamber pacing, leadless pacemakers offer a safe and effective alternative that allows for a quicker recovery period and no restrictions on activity level following implantation. This advancement in pacemaker technology signifies a major step forward in pediatric cardiology and electrophysiology.
In addition to this recent achievement, Cortez has a track record of being a pioneer in pediatric leadless pacing. He was the first physician in the world to implant a retrievable leadless pacemaker in a child in 2023, as well as the first to implant a Micra single-chamber leadless pacemaker through the internal jugular vein in a child five years prior. These groundbreaking procedures highlight Cortez’s dedication to advancing pediatric cardiac care and his commitment to exploring innovative technologies that benefit young patients with heart conditions.