Micra trans-catheter leadless pacemaker implantation in a patient with large right heart

Teruhiko Imamura; Takahisa Koi; Naoya Kataoka; Shuhei Tanaka; Hiroshi Ueno; Koichiro Kinugawa

doi:10.1016/j.jccase.2021.02.015

Micra trans-catheter leadless pacemaker implantation in a patient with large right heart

J Cardiol Cases. 2021 Mar 7;24(3):136-139. doi: 10.1016/j.jccase.2021.02.015. eCollection 2021 Sep.

Authors

Teruhiko Imamura¹, Takahisa Koi¹, Naoya Kataoka¹, Shuhei Tanaka¹, Hiroshi Ueno¹, Koichiro Kinugawa¹

Affiliation

¹ The Second Department of Internal Medicine, University of Toyama, Toyama, Japan.

Abstract

The use of leadless trans-catheter pacemakers is increasing particularly in the elderly population. However, its indication for those with anatomical anomaly remains unknown. We had a 75-year-old woman with atrial standstill and ventricular escape. Micra leadless pacemaker (Medtronic, Inc, Minneapolis, MN, USA) failed to be deployed due to too enlarged right atrium accompanied by atrial septal deficiency, followed by successful implantation of transvenous pacemaker lead by using SelectSecure lead (Medtronic) with a C315 delivery catheter that enhanced back-up force toward the ventricular septum against significant tricuspid regurgitation. The Micra is a promising system, but we should understand its limitations as well as alternative systems particularly for such an anatomical anatomy. <Learning objective: A Micra leadless trans-catheter pacemaker is a promising system with less invasiveness, particularly for elderly patients, but we should understand its technical limitation and consider alternative systems if necessary, particularly for those with enlarged right heart.>.

Keywords: Arrhythmia; Atrial fibrillation; Bradycardia; Heart failure.

Publication types

Case Reports