Snare-Assisted Flexion of 27-French Leadless Pacemaker Delivery Sheath: A Case Report.
Hemal Shah1, Marshall Winner1, Dilesh Patel1
1TriHealth Heart & Vascular Institute, Cincinnati, Ohio, USA.
Journal of Cardiovascular Electrophysiology
|January 24, 2025
Summary
A novel technique using a snare facilitated leadless pacemaker (LLPM) delivery in a patient with complex cardiac anatomy. This method improved sheath deflection and guided placement in the right ventricle.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Leadless pacemakers (LLPM) offer an alternative for patients with heart block.
- Standard LLPM delivery systems can face challenges in patients with complex cardiac anatomy.
Observation:
- A patient with intermittent complete heart block and prior surgical correction of an AV septal defect presented with significant right atrial enlargement.
- The standard delivery sheath for the ventricular LLPM could not adequately traverse the tricuspid valve due to anatomical challenges.
Findings:
- A snare was utilized to enhance the deflection of the LLPM delivery sheath, aiding its passage through the tricuspid valve.
- The snare facilitated precise guidance of the delivery sheath to the right ventricular septum, enabling successful LLPM fixation.
Implications:
- This technique demonstrates a viable strategy for overcoming anatomical barriers during leadless pacemaker implantation.
- The use of a snare offers a potential solution for improving LLPM delivery success rates in complex cardiac cases.
