First in man right atrial appendage implantation of a Micra leadless pacemaker

Abstract

Introduction: Pacemaker implantation can be challenging in patients with congenital heart disease.

Methods and results: In a patient with Ebstein disease and symptomatic sinus node dysfunction, despite multiple attempts, the Micra® pacemaker could not be implanted in the severely dilated right ventricle. In that context, and after iodine injection to confirm the appropriate location, the Micra® pacemaker was successfully implanted in the right appendage at the first attempt.

Conclusion: Despite the recent development of dedicated dual-chamber leadless pacemaker, to the best of our knowledge, this case is the first off-label Micra® implantation in a right appendage.

Keywords: Ebstein disease; leadless pacemaker; pacing; right appendage.