Navigating the Lead Paradox: Successful Co‐Implantation of Cardiac Contractility Modulation Device and a Micra Leadless Pacemaker
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.
Fields of Study & Subjects
Amyloidosis: Diagnosis
Treatment
Outcomes
Cardiac pacing and defibrillation studies
Thyroid and Parathyroid Surgery
Publication details
- Journal / source
- Journal of Cardiovascular Electrophysiology
- Volume
- 37
- Issue
- 2
- Pages
- 434–437
- Publication date
- 9 January 2026
- Language
- EN