Leadless pacemaker implant guided by intracardiac echocardiography in a patient after Mustard repair

Abstract

This case report describes a successful leadless pacemaker implant (Micra VR Medtronic, Inc, Minneapolis, MN) in a 48-year-old patient with a history of Mustard repair. Twenty-one years after dual-chamber pacemaker implant, both conventional leads became dysfunctional. Lead extraction was refused by the patient and the subclavian vein was obstructed. A leadless pacemaker was selected as an alternative. Intracardiac echocardiography allowed the safe introduction of the delivery system into the nonsystemic left ventricle. Four months after implant, the pacing parameters are stable and the patient is without new complaints. A leadless pacemaker could be considered in patients with complex grown-up congenital heart disease (GUCH).

Intracardiac echocardiography Chinese expert consensus

“…Nowadays, ICE has been applied in a variety of cardiovascular interventional operations. In addition to the applications introduced above, ICE can also be used to guide the implantation of leadless pacemaker (182), left bundle branch pacing (183), etc. At the same time, for patients who have implanted pacemaker, zero-fluoroscopy ablation can also be completed with the assistance of ICE (184).…”