Transient 2:1 Atrioventricular Block with Peri-Conduction System Pacing After Leadless Pacemaker Implantation

Figures

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  Fig. 1. Postdeployment intraoperative fluoroscopy in the right anterior oblique position demonstrates the leadless pacemaker's position in the mid-distal right ventricular septum.

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  Fig. 2. Postimplantation chest radiographs show (A) posterior-anterior and (B) lateral views of the leadless pacemaker's position in the mid-distal right ventricular septum.

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  Fig. 3. Electrocardiogram tracings. A) Holter monitor tracing obtained the evening after device implantation demonstrates a 2:1 AV block; (B) postimplantation telemetry tracing demonstrates the AV block and successful backup pacing, with QRS complexes of a similar electrical axis to native sinus conductiona; (C) the QRS duration of the paced complex measures 119 ms by caliper on telemetry.

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  Fig. 4. Paced QRS complexes at 1-year follow-up are comparable to native sinus conduction. ECG, electrocardiogram.