Micra vs Aveir

For anyone else considering leadless, here's what I've learned so far

Aveir is first generation, Micra is third generation.

Aveir is intended to be retrieved at end of life, Micra is left in. There have been Micras removed and it should get more common, but for now they are generally left in. 

Aveir does not have remote monitoring, Micra does.

Aveir can be implanted with two devices to give true dual chamber pacing. The two of them talking to each other significantly reduces the battery life, and the two devices will deplete at different rates resulting in two replacement surgeries. 

Micra they can do two also but it doesn't seem like very many do this. 

Micra can mimic dual chamber pacing by tracking the atria up to 105 bpm. Beyond that it uses rate response. The rate response uses both motion and temperature. When the atrial rate increases putting more oxygen in the blood, the blood temp drops enough that the Micra will know to increase the rate. 

Both have been implanted alongside existing traditional leads, however it's not common. 

Neither is going to give dual chamber pacing that is as effective as traditional leads but both can do the job.

 

 

13 Comments

Useful information

by piglet22 - 2024-11-09 19:10:16

Thanks Tracey.

I've got a replacement coming up in January, but I don't expect to have much say in the matter.

On balance, and preferring wired to wireless in most things, given a choice I'll stick with leads.

Small size shouldn't preclude Bluetooth and remote monitoring, but maybe the smaller battery prevents extras like BT.

I can imagine that trying to retrieve a device in a 100% dependent situation could be harrowing.

It's difficult to see what the advantages are other than problems with the leaded route.

Maybe for a first time implant, leadless might be a good choice, but I would need a good read of the manufacturers literature on pros and cons in the first instance.

Good info

by Lavender - 2024-11-09 20:09:06

So interesting! So which did you decide on, or will your doc choose?

Lavender

by Tracey_E - 2024-11-09 22:25:27

Both of my ep's have left the choice to me, but both recommended micra, which is what I've chosen after much discussion and deliberation. Much much discussion! Fortunately both are wonderful and willing to discuss with me at length so I'm informed and comfortable with my decision. 

Question

by Lavender - 2024-11-09 22:44:34

You've done your homework and it's good to be comfortable with your choice. Questions:

What is the average lifespan of a micra?

Will they remove your present leads?

 

Piglet

by Tracey_E - 2024-11-09 22:45:06

Problems with leads can be significant, esp as they age.
 

If your leads are good, there is no reason to make a change. I've done this through 5 devices, but now my 30 year old lead has given out and my left arm stays swollen from reduced circulation. Extraction is not as risky as it used to be but it's still a serious surgery. My choices are leave the old leads, live with the swollen arm and get new leads on the right side, or extract and do new leads on the right, or extract and go leadless. My veins on the left are done, a vascular surgeon will be involved to stent as needed after the leads are out. I don't want to be doing this again in 15-20 years so prefer not to get new leads if I can avoid it. 
 

I think over the next few years we are going to see leadless become the norm for new implants. It's a lot less hardware to break down. The technology isn't there yet to make it right for everyone, but it's close. 
 

being dependent is never an issue. They can use an external or temporary pacer during the procedure. The aveir has a retrieval device that attaches to it and removes.  Check out abbots website for a cool animation. Micra does not and is intended to be left in and just add a new one but the ep said that he has removed them, same way he gets old leads out. 

Lavender

by Tracey_E - 2024-11-09 22:56:17

Life on a micra is 10-12 years. 

they will attempt to extract the old leads, yes. 

Thanks for all the great info Tracey

by Good Dog - 2024-11-10 09:23:15

Your posts here are really helpful for anyone in a similar situation. It seems that you are making a very wise choice!

Sincerely,

Dave

Good luck Tracey

by Gemita - 2024-11-10 10:52:33

Tracey, we will all follow your progress with the leadless with great interest because if anyone can get the most out of it, it will be you with your considerable experience over the years fully challenging your pacemakers, yourself and your doctors.  

Micra will be lucky to have such an experienced athlete on board.  I wish you every success and a safe transition to a leadless device.

Onward and inward!

by Lavender - 2024-11-10 11:32:41

Looking forward to your progress notes! You're always teaching us! 😘

A great Service

by doublehorn48 - 2024-11-10 14:26:54

Thanks so much for taking the time to post this information. Someday most will have leadless pacemakers. As usual your comment is spot on. To me the most important thing you can do is finding the most qualified doctor for the procedure. And I'm sure you have covered that base. From your past comments you've always had a great attitude. I look forward to your comments after this procedure. As they say, it's the size of the fight in the dog that counts, and you have an excess of fight.

m. scott

Best of luck, Tracy

by athena123 - 2024-11-10 16:29:10

thanks for the informative post and all your contributions to this club.  good luck moving forward. 

Thanks for the Research Feedback

by SeenBetterDays - 2024-11-11 11:53:13

Thanks for all the helpful research and pros and cons of each system.  This will be a great help for those going through a similar decision making process in the future.  I'm sure you'll be relieved to get all those leads out and see an improvement to your blood flow.  I can imagine it's a daunting op but you always remain positive and mindset is incredibly important for a speedy recovery.  I really hope everything goes well for you Tracey and you are able to continue all your actvities and adventures!

Thank you, Tracey

by Julros - 2024-11-11 17:28:28

This all so interesting. Kudos to you for doing the research. 

Best of luck on your procedure, and of course, we all look forward to your recovery. 

You know you're wired when...

You can feel your fingers and toes again.

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