Can a Micra (Medtronic Micra, pacemaker) produce a Premature Ventricular Contraction (PVC) burden?

From the Guidelines

Yes, a Micra (Medtronic Micra, pacemaker) can produce a Premature Ventricular Contraction (PVC) burden.

PVC Burden and Cardiomyopathy

• The minimum PVC burden that appears to result in cardiomyopathy is 10% 1
• PVC burden ≥24% is independently associated with cardiomyopathy 1
• Frequent PVCs may be a reversible cause of LV dysfunction that can be effectively treated with catheter ablation 1

Diagnosis and Treatment

• Evaluation for multiple PVCs should include an ambulatory Holter monitor, echocardiogram, and exercise stress test 1
• Radiofrequency ablation resulted in normalization of EF in 82% of the patients with LV dysfunction within 6 months 1
• The RV outflow tract was the most common origin of PVCs (52% of cases) 1

From the Research

Micra Pacemaker and Premature Ventricular Contraction (PVC) Burden

• The provided studies do not directly address the question of whether a Micra pacemaker can produce a Premature Ventricular Contraction (PVC) burden 2, 3, 4, 5, 6.
• However, one study reports a case of ventricular fibrillation arrest following the implantation of a Micra leadless pacemaker, suggesting that the device may be associated with ventricular arrhythmias 4.
• Another study found that Micra implantation may be complicated by myocardial and vascular perforations and tears that result in cardiac tamponade and death, but it does not specifically mention PVC burden 2.
• The remaining studies focus on the safety and efficacy of Micra pacemakers, including comparisons with traditional transvenous pacemakers, and do not provide information on PVC burden 3, 5, 6.

Complications Associated with Micra Pacemakers

• The studies suggest that Micra pacemakers may be associated with various complications, including:
  • Cardiac tamponade 2
  • High capture thresholds 4
  • Ventricular arrhythmias, such as ventricular fibrillation 4
  • Myocardial and vascular perforations and tears 2
• However, the incidence of these complications is estimated to be low (<1%) 2.

Limitations of the Studies

• The provided studies do not specifically investigate the relationship between Micra pacemakers and PVC burden.
• The studies have different focuses, including the safety and efficacy of Micra pacemakers, and do not provide a comprehensive understanding of the device's potential to produce PVC burden.