Question: Is it possible to stop the issue of nocturnal non-capture in an Aveir VR LP without modification of the output voltage?
Answer: No, it is generally not possible to reliably resolve nocturnal non-capture in the Aveir™ VR LP leadless pacemaker without adjusting the output voltage (i.e., pacing amplitude or pulse width). Nocturnal non-capture often occurs due to elevated pacing thresholds during sleep, which can be influenced by autonomic tone, lead stability, or fibrosis at the implant site. The Aveir VR LP system allows for programmable output settings, and if non-capture is observed—especially at night—increasing the pacing output is the standard clinical response to ensure consistent capture.
Alternative strategies such as reprogramming the pacing vector are not applicable in the Aveir VR LP, as it is a single-chamber, single-vector leadless device. Therefore, output adjustment remains the primary and often necessary intervention.
Always consult the latest device manual and involve a cardiac electrophysiology specialist for patient-specific management.