FDA approved Abbott's Aveir VR Mini leadless pacemaker on September 15. The implant measures 32.5 mm, down from 38.0 mm on the current Aveir VR, a 14 percent cut. It paces the right ventricle in patients with slow heart rhythms.

Abbott is positioning VR Mini next to the Aveir AR2 atrial device as the next generation of its dual-chamber leadless system. The two implants communicate beat to beat over Abbott's i2i in-body link, which keeps atrial and ventricular pacing synchronized. Randel Woodgrift, who runs Abbott's cardiac rhythm management unit, called the pair the next generation of the only dual-chamber leadless pacing system on the market.

Medtronic's single-chamber Micra is still the smaller device at 25.9 mm, 6.6 mm shorter than the new Abbott implant.

Size is most of the argument in leadless pacing. It sets the delivery catheter profile and decides how much right-ventricular room is left for a second implant or a later revision. Abbott is spending millimeters on dual-chamber capability that Micra does not offer.