Chair Suneet Mittal (New York, US) led this session on dual-chamber leadless pacing, joined by Case Operator Devi Nair (Jonesboro, US) and panellists Rahul Doshi (Los Angeles, US) and James Ip (New York, US). The discussion focused on the Aveir dual-chamber leadless pacing system, which includes right atrial and right ventricular devices, delivery and retrieval catheters, and a programming module. Devi Nair presented a case of a 72-year-old male with malignant bradycardia and syncope, highlighting implantation steps. The ventricular device was positioned mid-septally, ensuring stability through impedance testing and pre-mapping. The atrial device was implanted at the right atrial appendage base, with ICE aiding placement.

The panel discussed procedural nuances, including vascular closure techniques, fluoroscopic views, and anatomical challenges. They compared passive and active fixation systems, highlighting active fixation’s benefits. The ability to upgrade from single- to dual-chamber pacing was seen as a paradigm shift in bradycardia management. The session concluded with optimism about leadless pacing’s future, offering modular, retrievable solutions for long-term patient care.