Transcatheter Leadless Cardiac Pacing with Limited Venous Access

Abstract

Entirely leadless cardiac pacemakers that are delivered transvenously required the use of large diameter delivery sheath and femoral venous approach. The complexity of external femoral and iliac venous anatomy may limit their implantation. We describe a patient without subclavian venous access and a conventional pacemaker with a failed right ventricular lead, who had difficult iliac venous anatomy that was also compressed by an external endovascular abdominal aortic stent. Successful leadless pacing using a Micra™ (Medtronic Inc) was accomplished with a strong support wire, hydrophilic delivery sheath and guided by venography. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.