{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:21:31Z","timestamp":1793287291503,"version":"4.5.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac Implantable Electronic Device infections increase short- and long-term mortality, along with healthcare costs. Leadless pacemakers (PM) were developed to overcome pocket- and minimize lead-related complications in selected high-risk patients. Recent advancements enable leadless devices to mechanically detect atrial activity, facilitating atrioventricular (AV) synchronous stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>A 90-year-old woman, implanted with a dual-chamber pacemaker eight years ago due to sinus node dysfunction, presented with syncope. A diagnosis of complete AV block, in the setting of ventricular lead dysfunction was made. Due to a high risk of infection, the patient was implanted with a leadless PM capable of maintaining AV synchrony in VDD mode (MICRA\u2122 model MC1AVR1). The transvenous PM was programmed to AAI-R mode to drive the atria, which, in turn, triggered the leadless PM to stimulate the ventricles. At six month follow-up, the AV synchrony rate was 85%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of classic atrial pacing with leadless ventricular stimulation can be used in high-risk patients to reduce the risk of complications, in the setting of ventricular lead dysfunction. In this manner, AV synchrony can be maintained, improving hemodynamic parameters and quality of life. Low sinus rate variability at rest is essential to achieve a high AV synchrony rate in such cases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1287506","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T04:21:32Z","timestamp":1699849292000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: A leadless and endovascular pacemaker teamwork"],"prefix":"10.3389","volume":"10","author":[{"given":"Sarah","family":"Zeriouh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Sousonis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Men\u00e8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Voglimacci-Stephanopoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Combes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1001\/archinternmed.2011.441","article-title":"Mortality and cost associated with cardiovascular implantable electronic device infections","volume":"171","author":"Sohail","year":"2011","journal-title":"Arch Intern Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1161\/CIRCULATIONAHA.106.678664","article-title":"Risk factors related to infections of implanted pacemakers and cardioverter-defibrillators","volume":"116","author":"Klug","year":"2007","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1093\/europace\/eux387","article-title":"Infections and associated costs following cardiovascular implantable electronic device implantations: a nationwide cohort study","volume":"20","author":"Cl\u00e9menty","year":"2018","journal-title":"Europace"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC). 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