IMR Press / RCM / Volume 23 / Issue 4 / DOI: 10.31083/j.rcm2304125
Open Access Case Report
Leadless pacemaker implantation in superobese patient
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1 Cardiology Unit, Sant’Anna Hospital, University of Ferrara, 44124 Ferrara, Italy
2 Vascular surgery Unit, Sant’Anna Hospital, University of Ferrara, 44124 Ferrara, Italy
*Correspondence: matteo.bertini@unife.it (Matteo Bertini)
Academic Editor: Giacomo Mugnai
Rev. Cardiovasc. Med. 2022, 23(4), 125; https://doi.org/10.31083/j.rcm2304125
Submitted: 25 November 2021 | Revised: 29 December 2021 | Accepted: 11 January 2022 | Published: 2 April 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: A 70 years-old superobese man (weighted 230 kg) was referred to our hospital for recurrent syncope due to asystole alternating to atrial fibrillation. Convectional pacing was highly challenging; therefore, it was decided to implant a leadless pacemaker in a multidisciplinary intervention with surgical management of the femoral venous access. Methods: In a fully equipped operating room with bariatric table and appropriately dimensioned fluoroscope, a vascular surgeon performed surgical isolation of the right common femoral vein. After that, we proceeded to insert sheaths via the femoral vein, and through that a steerable transcatheter delivery system for the device. Results: The implant was successful without complication. Conclusions: Leadless pacemaker implantation can be effectively and safely performed even in superobese patients. Vascular access, fluoroscopic guidance and electronic interrogation could be easily managed and do not constitute a limit.

Keywords
Leadless pacemaker
Super obesity
Vascular surgery
Fluoroscopy
Figures
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