Key result
ICE and voltage mapping enable safe atrial leadless pacemaker deployment in double mechanical valve disease.
ICE and voltage mapping can successfully guide atrial leadless pacemaker implantation in complex patients with double mechanical valves and extensive atrial scarring.
May enable pacing options in extensive atrial scarring; leaves open need for larger trials on durability and outcomes.
A and B: Right atrial voltage mapping identified a limited region of viable myocardium within an extensive atrial scar. C: Intracardiac echocardiography guided safe deployment of an atrial leadless pacemaker. D and E: Fluoroscopy confirmed stable device positioning in the right atrial appendage of the patient.
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Ngarmukos et al. (2026) studied this question. Intracardiac echocardiography and voltage mapping enabled safe deployment of an atrial leadless pacemaker in a patient with double mechanical valve disease and extensive scar.
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