Introduction Lead extraction and reimplantation in adult congenital heart disease (CHD) patients is challenging due to anatomical complexity. Case A 76‐year‐old man with prior ventricular septal defect (VSD) patch repair and pacemaker implantation developed a device infection. Complete transvenous lead extraction (TLE) was achieved using laser and mechanical sheaths. A leadless pacemaker (Aveir VR) was implanted at the right ventricular outflow tract (RVOT) using pre‐fixation mapping to avoid the VSD patch. Conclusion This case illustrates the effectiveness of pre‐mapping in achieving safe reimplantation of a leadless pacemaker after TLE in complex CHD anatomy.
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Misonou et al. (2025) studied this question.
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