Abstract 10052: Leadless Pacemaker and Deep Brain Stimulator: Proximity Without Interference

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Introduction: Deep Brain Stimulator (DBS) treatment is a known form of treatment for advanced Parkinson’s disease refractory to medical therapy. With the current aging population, instances where cardiac implantable electronic devices are becoming more frequent. Due to risk of complications from implantation of both devices, literature has recommended keeping a minimum distance of 20cm (or 6in) between the two generators. In this case we have demonstrated a successful leadless pacemaker placement at 37mm apart without any complications. Case Report: 75 year old female with past medical history of essential tremor status post left VIM and VOA/VOP deep brain stimulator placement in 2019 presented to the emergency department with chief complaint of fall secondary to weakness. Electrocardiogram demonstrated Afib with RVR. Heparin was started for anticoagulation as the patient's CHADSVASC score was noted to be 5. Rate control was unsuccessful despite attempts with Metoprolol, digoxin loading, and max use of intravenous Cardizem. Cardioversion was not an option as the patient would need to commit to 4 weeks of uninterrupted therapeutic anticoagulation and be unable to undergo lung biopsy for new found lung mass. Extensive discussion was held with the patient and it was determined to proceed with AV nodal ablation with leadless pacemaker placement. Patient underwent successful placement of the Medtronic MC1VR01 US leadless pacemaker 37mm apart from the prior DBS device. Patient’s heart rate after the procedure remained stable at the lower rate of 80bpm with follow up device check in clinic showing no complications or interference among devices.

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