

Episode 315: What's New In Leadless Pacing with Drs. Tang, Holloway and Iyer
Aug 24, 2025
Join experts Dr. Manoj Iyer, Dr. Jonathan Tang, and Dr. Jordan Holloway as they delve into the exciting world of leadless pacing technology. Discover the advancements in devices like the Micra and Avere, which are transforming cardiac care. They discuss the challenges and innovations in implantation techniques and the integration of subcutaneous ICDs with leadless pacemakers. Explore how these developments aim to enhance patient outcomes and address arrhythmia management, especially in younger patients.
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Leadless Devices Reduce Venous Complications
- Leadless systems avoid venous leads and reduce infections, venous thrombosis, tricuspid valve injury, and extraction risks.
- This shift reframes pacing strategy toward minimizing long-term vascular complications.
Micra Is Ventricular-Only And Motion-Sensing
- The Micra devices are implanted via femoral access into the RV mid-septum and only provide ventricular pacing.
- Early Micra models rely on motion sensing rather than electrical atrial sensing, limiting AV synchrony.
Micra Evolved To AV Sensing And Longer Life
- Micra AV added atrial sensing via an improved accelerometer to allow AV‑synchronous RV pacing.
- Newer AV2/VR2 models improved algorithms and extended battery life to ~16–17 years.