Work

Navigating the Lead Paradox: Successful Co‐Implantation of Cardiac Contractility Modulation Device and a Micra Leadless Pacemaker

Year: 2026

Type: article

Abstract: BACKGROUND: Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) can lead to refractory heart failure. A "lead paradox" occurs when patients with a Micra leadless pacemaker require lead-based Cardiac Contractility Modulation (CCM) therapy. CASE SUMMARY: We detail the first co-implantation of CCM and Micra devices in a 78-year-old male with ATTRwt-CA and NYHA III heart failure. A multi-view fluoroscopic technique ensured spatial separation, while specific device programming mitigated electrical crosstalk post-procedure. CONCLUSION: At 1 year, the patient stabilized to NYHA Class II without further hospitalizations. This dual-device strategy is a feasible and safe technical roadmap for this complex clinical problem.

Source: Journal of Cardiovascular Electrophysiology

DOI: 10.1111/jce.70244

Authors: Gabriele Pavani, Paolo Garrone, Gianpaolo Varalda, Antonino Previti, Matteo Bianco, Alessandra Chinaglia

Institutions: Ospedale San Luigi Gonzaga, University of Turin

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,500