Leadless pacemaker implantation in achondroplastic dwarfism and recurrent cardiac implantable electronic device infections: a case report

The safety and performance of the micra thranscatheter pacing system (MTPS) seems to be very high both in the investigational studies and in the real world setting. Much of currently available data comes from normal-sized adults, with only limited data on small-sized patients. We describe the MTPS implantation in a 71-year-old male, suffering from recurrent pacemaker infections and lead failure, who is affected by achondroplastic dwarfism with the pathognomonic phenotypical signs characterized by small size (height 120 cm; weight 39 kg), disproportionately short upper limbs, often limiting self-care skills, with an abnormal limb-to-trunk ratio. Other comorbidities include type 2 diabetes and severe thoracolumbar kyphosis. Previously, in 1970, the patient underwent a single-chamber pacemaker implantation via the right subclavian vein for complete atrioventricular block. Due to recurrent ventricular lead failure, a contralateral pacemaker implantation via the left subclavian vein was performed in