3D computed tomography integration guiding permanent Aveir AR leadless pacemaker implantation: a case report

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Single-chamber right ventricular (RV) leadless pacemakers (LPs) are established.
• The advent of right atrial LPs enables dual-chamber leadless pacing.
• Cardiac computed tomography (CT) segmentation offers potential procedural guidance.

Observation:

• A 58-year-old male presented with dizziness and complete heart block.
• The patient initially received a single-chamber permanent LP.
• An upgrade to a dual-chamber LP involved using 3D CT image fusion with fluoroscopy.

Findings:

• 3D CT image fusion precisely identified the optimal implantation site for the dual-chamber LP.
• This technique facilitated accurate and safe device placement.
• The procedure aimed to upgrade a single-chamber system to a dual-chamber one.

Implications:

• Integrating CT image guidance with fluoroscopy can improve procedural safety.
• This approach may increase the success rates of leadless pacemaker implantation.
• Utilizing CT guidance has the potential to reduce overall fluoroscopy time for patients.