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Atrioventricular nodal ( AVN ) ablation and right ventricular ( RV ) pacing is recommended for refractory atrial fibrillation ( AF ) and tachycardia‐bradycardia syndrome. Three  AF  patients (mean age 83, range 79‐89 years) underwent  AVN  ablation and transvenous leadless pacemaker Micra ™  implantations using the same venous access without anticoagulation interruption. Satisfactory pacing 0.59 (0.50‐0.63) V at 0.24 ms and sensing 11.2 (6.3‐15.6)  mV  were achieved within 1‐3 deployments. There were no vascular complications nor device dislodgment. Durable pacemaker parameters and  VVIR  pacing were achieved. Combined  AVN  ablation and leadless pacemaker implantation is feasible and safe, and avoids pacemaker pocket hematoma and bleeding complications in patients on uninterrupted anticoagulation.

One stage atrioventricular nodal ablation and leadless pacemaker implantation for refractory atrial fibrillation