Korean Circ J.  2023 Apr;53(4):271-272. 10.4070/kcj.2022.0305.

Leadless Pacemaker Implantation in Renal Dialysis Patient With No Vascular Access

• Afendoulis D
• Voutas P
• Papagiannis N
• Moutafi M
• Sitaras P
• Maratsos A
• Sideris S
• Kartalis A

• KMID: 2542298
• DOI: http://doi.org/10.4070/kcj.2022.0305

Figure

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  Figure 1 (A) Photo taken from patient’s chest depicting the presence of varicose thoracic veins (red arrow). (B) Computed tomography angiography with IV contrast sagittal view, depicting the presence of bilateral obstruction of subclavian veins (red arrows). Notable is the length of obstruction of the left subclavian vein being 2.94 cm. (C) Computed tomography angiography with IV contrast axial view, depicting the presence of thoracic varicose veins and the IV-contrast remaining at the site of the left subclavian vein due to obstruction (contrast was given from left arm- red arrow). (D) Chest X-ray taken after the pacemaker implantation depicting the presence of leadless pacemaker (red arrow).IV = intravenous.

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  Figure 2 Patients electrocardiogram after pacemaker implantation depicting the presence of pacemaker rhythm (native atrial rhythm with complete heart block and single chamber VVI pacing- iatrogenic atrioventricular dissociation).

Reference

1. Glikson M, Nielsen JC, Kronborg MB, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021; 42:3427–3520. PMID: 34455430.

2. El-Chami MF, Clementy N, Garweg C, et al. Leadless pacemaker implantation in hemodialysis patients: experience with the micra transcatheter pacemaker. JACC Clin Electrophysiol. 2019; 5:162–170. PMID: 30784685.