Micra AV Education

• by erichlin
• 2022-12-12 17:12:03
• Checkups & Settings
• 464 views
• 0 comments

So i posted this on the Micra AV group on Facebook. Please go there for comments, and further information. ( https://www.facebook.com/groups/1533131873540969/posts/2138193303034820/ )

I've been thinking about teaching people about their Micra AV from a technical standpoint. Understanding exactly how the device programming works and where device techs and Micra AV fall short.

From my research, a lot of people who have Micra AV are poorly tracked, either symptomatically or asymptomatically without realizing it.

I could hold a video meeting if people are interested. I won't be able to help ones with Micra VR, but some principles might translate such as the rate response stuff.

However, it'll make people realize just how bad the Micra AV has been marketed and how many are possibly at risk of pacemaker syndrome. And it would be nearly impossible for techs to help out patients in the clinic, both due to lack of proper education and due to the variability of the heart in different environments.

I would also easily be able to demonstrate to any person if their settings are appropriate or not so they don't have to rely on their tech to tell them "everything is okay". You can objectively do this yourself and "score" them with a report card.

The situation is the worse for people who need to be paced most of the day. The situation is significantly better for those that don't require much pacing because the Micra AV can use the AV conduction mode switch or increase the sensed AV interval, allowing intrinsic conduction most of the time

Imo, the only reason people are feeling relief from Micra AV is due to the reduction of bradycardia. But they sacrifice that symptomatic bradycardia for asymptomatic AV dyssynchrony. And no EP is really tracking this since usually the Medtronic tech just checks the device for what the AV synchrony is, which is obfuscated. It's measuring the ruler with the table. You should not be using the Medtronic device to determine if you have AV synchrony if it itself doesn't really know. You MUST use a ECG device that can record for 24 hours. It's the only way to tell if you are tracking correctly.

Btw, the device I recommend is Fourth Frontier. Medtronic really needs to work on this marketing and ignorance and poor post-operation followup.

I've been neglecting posting this for a while, but the incompetence from Medtronic is frustrating. Fortunately , I've improved my report card significantly to hopefully reduce the risk of pacemaker syndrome and other iatrogenics.

But the stories I have of incompetence would not only scream criminal, but also can be featured on a "Bleeding Edge" documentary.