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User question:
What are the differences between the Aveir VR and the Micra that it is important to understand because makes the Aveir VR unique if an anesthesiologist were to come across one preoperatively?
Claude AI answer:
As an anesthesiologist encountering these devices preoperatively, there are several key differences between the Aveir VR and the Micra leadless pacemakers that are important to understand:
1. Retrieval capability: The Aveir VR is designed to be fully retrievable at any time after implantation. This is a unique feature compared to the Micra, which is only designed for acute retrieval shortly after implantation. The retrievability of the Aveir VR could be relevant for future procedures or device management.
2. Battery life: The Aveir VR typically has a longer projected battery life (approximately 9-10 years) compared to the Micra (around 7-8 years). This difference might impact long-term management plans.
3. Size: The Aveir VR is slightly larger than the Micra. While both are miniaturized compared to traditional pacemakers, the size difference could potentially affect imaging or other procedural considerations.
4. Fixation mechanism: The Aveir VR uses a unique active fixation mechanism with electrically conductive side helix, while the Micra uses small tines for fixation. This difference in fixation could be relevant if considering device interaction or potential removal.
5. Rate response mechanism: The Aveir VR uses a temperature-based rate response sensor, whereas the Micra uses an accelerometer. This might influence how the device responds to physiological changes during anesthesia and surgery.
6. MRI compatibility: While both devices are MRI conditional, the specific conditions and protocols may differ. It's important to verify the exact MRI compatibility parameters for each device.
7. Programming and communication: The Aveir VR uses a different communication protocol (conductive communication) compared to the Micra's radiofrequency communication. This might affect how the device is interrogated or programmed perioperatively.
8. Manufacturer: The Aveir VR is manufactured by Abbott, while the Micra is made by Medtronic. This could influence the availability of technical support or specific device information if needed urgently.
Understanding these differences can help anesthesiologists tailor their perioperative management, especially regarding electromagnetic interference, rate response behavior, and potential device interactions. It's always advisable to consult with a cardiac electrophysiologist or the device manufacturer for specific management recommendations when encountering these devices.
