Authors: Souleiman Salameh, Daniel Cortez
Published: 2023-06-15
DOI: 10.1161/circ.146.suppl_1.13296
Source: Full article
Pacemaker placement in pediatrics involves consideration for potential complications with leads, pocket erosion and infection. Pacemaker generators also carry their own complications such as hematoma formation and additional infection. This is why a reliable leadless pacemaker implantation technique is desired. In this dual center, single operator, retrospective study we demonstrate the feasibility of leadless pacemaker implantation via internal jugular vein in patients under 30 kg. This technique does not require surgical cut-down and preserves the patency of the involved vessels. Procedures were conducted by an electrophysiologist at the University of Minnesota and UC Davis Medical Center and University of Minnesota Medical Center from 2018-2021 with the Micra (Medtronic, Minneapolis, MN, USA). Vascular access in the largest diameter internal jugular vein was obtained in the right or left internal jugular veins via the Seldinger technique with serial dilation from 5 or 8 French size to 27 French. Results showed that in eight patients under 30kg, leadless pacemaker can implanted via the internal jugular vein with no need for surgical cut down due to having good short-term and mid-term vein patency. Seven out of eight patients were discharged the next day after the procedure. No venous complications related to access were noted. All patients met an indication for pacemaker implantation with ventricular-only pacing needed or had prophylactic leadless pacemaker placed or was the patient and cardiology team preference after multi-disciplinary discussion. We recommend echocardiographic guidance to minimize perforation risk.