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Subclinical cardiac perforation caused by a Micra™ leadless pacemaker
Ikuko Togashi1, Toshiaki Sato2, Kyoko Hoshida1
1Cardiology Kyorin University School of Medicine Mitaka Japan.
Journal of Arrhythmia
|June 29, 2018
Summary
A rare complication of Micra™ transcatheter pacing system, cardiac perforation, was identified. Careful review of imaging before deployment is crucial to prevent this serious adverse event.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Imaging
Background:
- The Micra™ transcatheter pacing system offers a leadless solution for cardiac pacing.
- Device placement involves positioning the cup on the right ventricular septum.
Observation:
- Subclinical cardiac perforation occurred during Micra™ implantation.
- Contrast media injection revealed contrast outside the myocardium, within the pericardium.
- Cardiac CT identified a diverticular structure on the right ventricle.
Findings:
- The Micra™ device cup perforated the right ventricle.
- Contrast material extravasated into the pericardial space.
- A diverticular structure was noted on the right ventricle.
Implications:
- This case highlights a potential risk associated with Micra™ transcatheter pacing.
- Careful pre-deployment imaging review, particularly the right anterior oblique view, is essential.
- Ensuring proper device orientation away from the septum-free wall border can prevent perforation.
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