World’s First Dual-Chamber Leadless Pacemaker Now Available for Patients with Abnormally Slow Heart Rhythm

MedStar Washington Hospital Center is one of a select few institutions nationwide now offering patients with abnormally slow heart rates breakthrough technology that delivers treatment by a revolutionary new technology: two tiny leadless pacemakers implanted within the heart.

The Aveir™ DR Leadless Pacemaker System was tested as part of a clinical trial that included MedStar Washington Hospital Center, and it received regulatory approval in June 2023. On Monday, Nov. 6, the heart rhythm team at MedStar Washington implanted the Washington region’s first approved leadless dual-chamber pacing device in two patients. Their procedures went well and both patients stayed overnight for observation and are now resting at home. Several hospitals, including MedStar Washington, simultaneously became the first centers in the country to offer this technology.

Patients of any age, but most commonly older people, can experience abnormal slowing of the pulse, which may cause fatigue, dizziness, passing out, and diminished quality of life. Traditional pacing therapy has required threading wires through a vein to the heart and connecting them to a metal, disc-shaped pacemaker implanted under the skin of the chest.

The leadless system consists of two tiny pacemakers, each smaller than a AAA battery, that are inserted via a catheter in a large vein in the thigh. Under X-ray guidance and without any incisions, the two devices are secured within the upper and lower chambers of the heart, respectively, to normalize its rhythm.

“The leadless dual-chamber pacemaker is an excellent option to treat abnormally slow heart rates,” said Cardiac Electrophysiologist Cyrus Hadadi, MD, associate director of Cardiac Arrhythmia Research at MedStar Washington Hospital Center. “There are no wires implanted in veins, no metal device under the skin, and no surgical incision. This means the potential for less risk, greater comfort, and fewer post-procedure restrictions.”

Compared to traditional pacing, leadless technology can eliminate inflammation, scars, and long-term problems, such as wire insulation breaks, vein blockage, and device infection. The procedure typically takes less than an hour, and patients can go home the same day.

Most patients needing pacemaker therapy require dual-chamber systems to best regulate their rhythm, and this requires an information exchange between both heart chambers. “The Aveir™ DR system uses the patient’s own blood, rather than wires, to transmit electrical information between the heart’s upper and lower chambers—a very clever and energy-efficient innovation,” added Dr. Hadadi.

In May 2022, the MedStar cardiac electrophysiology team was also the first in the Washington region to implant the Aveir™ VR single-chamber leadless pacemaker, and in July 2022, it was the first in the region to implant the Aveir™ DR pre-approval, experimental dual-chamber leadless pacemaker system.

MedStar Washington Hospital Center is a not-for-profit, 912-bed, teaching and research hospital in the nation’s capital, and is a major referral center for treating the region’s most complex cases. Its cardiology program is highly acclaimed, and its cardiac surgery program has consistently earned the highest national rating–three stars–from the Society of Thoracic Surgeons. MedStar Washington operates the region’s first Comprehensive Stroke Center and the District’s only Cardiac Ventricular Assist Device program, both certified by The Joint Commission. The hospital is also home to MedSTAR, a nationally verified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and it operates the region’s only adult Burn Center.


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