Stanford Health Care has been at the forefront of the latest advances in cardiovascular care for decades. As worldwide leaders in innovative therapies for arrhythmias and other heart conditions, Stanford Health Care continues to pioneer groundbreaking treatments.

In June of 2024, a cardiac electrophysiologist at Stanford Health Care successfully implanted the institution’s first leadless dual chamber pacemaker, Abbott Aveir DR. This groundbreaking treatment is designed for patients who need pacing in two chambers of the heart. It includes two devices, one that is implanted in the right atrium (top chamber) and the other in the right ventricle (bottom chamber).

Both devices are implanted through a vein in the leg as part of a minimally invasive procedure. Using advanced wireless technology, which includes power-efficient conducted electrical signals, the devices communicate with each other to provide synchronous sensing and pacing without the risk of complications associated with traditional pacemaker leads.

Pioneering innovative treatments
"Stanford Health Care is the only academic institution in the region currently performing this procedure," says Alexander C. Perino, MD, a cardiac electrophysiologist at Stanford Health Care and assistant professor of cardiac electrophysiology at Stanford University School of Medicine.

"This revolutionary technology expands our leadless pacing options, ensuring that our patients have access to the right device to treat their heart condition,” he says. Dr. Perino is also the medical informatics director for the Division of Cardiovascular Medicine and the associate director of inpatient electrophysiology at Stanford University School of Medicine.

Although pacemakers requiring leads are effective at treating slow heart rates and other arrhythmias, they include a range of potential complications, such as a higher risk of infection and lead fracture, and they often result in noticeable scars and/or device protrusion at the implantation site in the chest. Until recently, leadless pacemakers were an option for a minority of patients who required a pacemaker, as they could only pace the bottom chamber of the heart. The Stanford Health Care team is committed to making this innovative and effective treatment available to more people, including patients with sinus node dysfunction and chronotropic incompetence and those for whom transvenous leads are not preferred.

Benefits of the dual chamber leadless pacemaker
This sophisticated technology offers several benefits to both patients and physicians, including:

• Effectiveness: The pacemaker has been proven to work effectively in several positions and during activities, including when the patient is lying down, sitting, standing, and walking.
• Fewer post-procedure restrictions: Following implantation, patients should avoid heavy lifting for two weeks. In contrast, patients with transvenous pacemakers must avoid heavy lifting for at least one month and should not lift their arm above their head.
• Increased battery life: The batteries last longer as compared to other leadless pacemakers. This means patients will need fewer procedures to replace the devices over time.
• Precise placement: Physicians can map the heart before positioning the device, resulting in fewer repositioning attempts and better outcomes.
• Reduced risk of complications: Leadless technology eliminates the risk of lead- and pocket-related complications.
• Small implant size: The device is smaller than a AAA battery and invisible after implant.
• Straightforward retrieval: The devices are designed to be screwed into the heart muscle, and they can be “unscrewed” for easier retrieval and replacement.