Going Leadless: A Case-based Approach to Leadless Pacing in Challenging Cases-Going Leadless: A Case-based Approach to Leadless Pacing in Challenging Cases

Video Transcription

Video Summary

The session delved into the intricacies of leadless pacing, particularly focusing on challenging cases such as congenital heart disease, tricuspid valve disease, lead extraction, and patients requiring ICDs. The session, titled "Going Leadless," was moderated by Dr. Jamie Manluku and held at HRS in San Diego. It explored various case studies, emphasizing decision-making and procedural adaptations when traditional pacemakers present complications due to patient anatomy or infection risks.<br /><br />Dr. Mary Gleba presented cases on adult congenital heart disease, highlighting situations like a 63-year-old with dizziness due to prior heart surgery and pacemaker issues, and a 45-year-old Epstein's anomaly patient expressing preference for a leadless pacemaker. Dr. Aaron Bender discussed leadless pacing in tricuspid valve disease cases and the importance of considering geometry and angulation during implantation to avoid complications. A focus was on the placement of leadless pacemakers ahead of, during, or after valve interventions.<br /><br />Dr. Theofani Mela shared insights on leadless pacing in lead extraction patients, showcasing a complex case of a man with multiple surgeries and infections, emphasizing the low infection rates of leadless systems even in bacteremia-present cases. Dr. Puneet Jain then explored the integration of leadless pacemakers in patients with ICD indications, presenting a case where a patient required leadless pacing combined with a subcutaneous ICD to manage infections.<br /><br />Finally, Dr. Matthew Zipsy discussed atrial leadless pacing, including a case where a device had dislodged into the pulmonary artery, and how it was successfully retrieved. Throughout, the session highlighted the evolving landscape of pacing technology, which allows for more tailored and less invasive solutions for complex cardiac cases.

Keywords

leadless pacing

congenital heart disease

tricuspid valve disease

lead extraction

ICD integration

pacemaker complications

HRS San Diego

procedural adaptations

infection risks

pacing technology