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Case Reports
. 2022 Apr 2;23(4):125.
doi: 10.31083/j.rcm2304125. eCollection 2022 Apr.

Leadless pacemaker implantation in superobese patient

Michele Malagù  1 , Emanuele D'Aniello  1 , Francesco Vitali  1 , Cristina Balla  1 , Vincenzo Gasbarro  2 , Matteo Bertini  1
Affiliations
Case Reports

Leadless pacemaker implantation in superobese patient

Michele Malagù et al. Rev Cardiovasc Med. .

Abstract

Background: A 70 years-old superobese man (weighted 230 kg) was referred to our hospital for recurrent syncope due to asystole alternating to atrial fibrillation. Convectional pacing was highly challenging; therefore, it was decided to implant a leadless pacemaker in a multidisciplinary intervention with surgical management of the femoral venous access.

Methods: In a fully equipped operating room with bariatric table and appropriately dimensioned fluoroscope, a vascular surgeon performed surgical isolation of the right common femoral vein. After that, we proceeded to insert sheaths via the femoral vein, and through that a steerable transcatheter delivery system for the device.

Results: The implant was successful without complication.

Conclusions: Leadless pacemaker implantation can be effectively and safely performed even in superobese patients. Vascular access, fluoroscopic guidance and electronic interrogation could be easily managed and do not constitute a limit.

Keywords: Fluoroscopy; Leadless pacemaker; Super obesity; Vascular surgery.

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Conflict of interest statement

The authors declare no conflict of interest. Matteo Bertini is serving as one of the Editorial Board members/Guest editors of this journal. Cristina Balla is serving as one of the Editorial Board members. We declare that Matteo Bertini and Cristina Balla had no involvement in the peer review of this article and have no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Giacomo Mugnai.

Figures

Fig. 1.
Fig. 1.
Electrocardiogram strip showing asystole alternating to atrial fibrillation.
Fig. 2.
Fig. 2.
Surgical isolation of femoral vein (blue arrow) and artery (orange arrow).
Fig. 3.
Fig. 3.
Intraoperative fluoroscopy (left) and postoperative chest X-rays (right). Note the position of temporary pacemaker in right ventricular outflow tract (white arrow). Visualization of leadless pacemaker (and transcatheter delivery system) was of good quality with intraoperative fluoroscopy (left panel, black arrow) and of insufficient quality with chest X-rays (right panel).
See this image and copyright information in PMC

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