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Transcatheter Leadless Cardiac Pacing in Renal Failure with Limited Venous Access
Author(s) -
LAU CHUPAK,
LEE KATHY LAIFUN
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12895
Subject(s) - medicine , venography , venous access , hemodialysis , femoral vein , venous return curve , cardiology , surgery , cardiac pacing , radiology , catheter , hemodynamics , thrombosis
Entirely leadless cardiac pacemakers that are delivered transvenously required the use of large‐diameter delivery sheath and femoral venous approach. The complexity of external femoral and iliac venous anatomy may limit their implantation. We describe a hemodialysis patient without subclavian venous access and a conventional pacemaker with a failed right ventricular lead, who had difficult iliac venous anatomy that was also compressed by an external endovascular abdominal aortic stent. Successful leadless pacing using a Micra™ (Medtronic Inc., Minneapolis, MN, USA) was accomplished with a strong support wire, hydrophilic delivery sheath, and guided by venography.