What does this research mean for the field?

Inadvertent placement of a leadless Micra pacemaker into the left ventricle can occur as a rare complication through an undiagnosed patent foramen ovale during transcatheter implantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This report aims to describe a rare complication of the leadless Micra pacemaker implantation.

January 1, 2025Texas Heart Institute JournalOpen Access

Accidental Left Ventricular Placement of a Leadless Micra Pacemaker Through a Patent Foramen Ovale

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Accidental left ventricular placement of a leadless pacemaker (n=1). Intervention: Micra leadless pacemaker.

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Key result

Inadvertent LV leadless pacemaker placement via PFO linked to ischemic stroke 1 year later.

Key Points

This report aims to describe a rare complication of the leadless Micra pacemaker implantation.
Presented a case of accidental placement of a Micra pacemaker in the left ventricle
Investigated the associated patent foramen ovale
Described the transcatheter approach used for implantation.
Inadvertent placement of the leadless pacemaker in the left ventricle was confirmed
The complication was attributed to a previously undiagnosed patent foramen ovale.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 92-year-old man with a history of sick sinus syndrome and prior Micra leadless pacemaker placement who presented with an acute ischemic stroke due to accidental left ventricular placement of the device through a patent foramen ovale.

Intervention

Leadless pacemaker implantation

Preprocedural evaluation of cardiac anatomy using multiple imaging modalities is crucial to prevent inadvertent left ventricular placement of leadless pacemakers through undiagnosed septal defects.

Limitations

Lack of evidence regarding the thrombogenicity of leadless pacemakers
Difficulty in claiming with certainty that the stroke was related to the misplaced device versus the patient's underlying atrial fibrillation

Discussion

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Implication

May indicate delayed stroke risk from undiagnosed PFO during Micra implantation; leaves open whether routine preprocedural imaging is warranted.

Cite This Study

Alkowatli et al. (2025) conducted a case report in Accidental left ventricular placement of a leadless pacemaker (n=1). Micra leadless pacemaker was evaluated. A 92-year-old man experienced an acute ischemic stroke one year after a Micra leadless pacemaker was inadvertently placed in the left ventricle through an undiagnosed patent foramen ovale.

synapsesocial.com/papers/6a26297be9adcd92e9d58fd7 https://doi.org/10.14503/thij-23-8303

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Implication

May indicate delayed stroke risk from undiagnosed PFO during Micra implantation; leaves open whether routine preprocedural imaging is warranted.

Accidental Left Ventricular Placement of a Leadless Micra Pacemaker Through a Patent Foramen Ovale

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Accidental Left Ventricular Placement of a Leadless Micra Pacemaker Through a Patent Foramen Ovale

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider