Permanent Pacemaker (Lead-Less) Implantation

Mr Surya Kant Gupta was diagnosed with K/c/o HTN, T2DM, CKD, Post PTCA (2016), and Complete Heart Block. The surgery was performed using the smallest pacemaker (leadless) implanted on July 10, 2022. 

Procedure:

• After preparation and drape, the patient was given local anaesthesia and the femoral vein was punctured and an 8F sheath was placed.

• Then a Terumo wire was inserted through femoral access followed by a multipurpose catheter. Then, the Terumo wire was exchanged for an amplatz super stiff wire and super stiff wire. The surgeon does sequential dilation of the femoral vein puncture site with 12F and 20F dilatation. 

• Then a 23F sheath was inserted into the inferior vena cava and the delivery system of Micra was guided through the sheath and advanced up to RV mid septum. 

• After confirmation of good contrast, the Micra VDD – Medtronic was delivered. Subsequently, a tug test was done in multiple views which confirmed the procedure to be well engaged.

• After cutting the thread, the delivery system was withdrawn to remove the sheath and the femoral puncture site was sutured.