External DC Shocks of Symptomatic Supraventricular Tachycardia During Screw-In Leadless Pacemaker Implant: A Case Report.

We present the case of a 64-year-old man who, during the implantation of an active-fixation leadless pacemaker (LP, Aveir VR, Abbott, USA), underwent several external defibrillation shocks up to 240 Joules, due to symptomatic sustained supraventricular tachycardia at 160 bpm. The shocks, delivered both before and after the screwing of the device in the low interventricular septum, did not cause any technical damage to the device, and no complications were observed. The device was then deployed successfully. To our knowledge, this is the first documented case of external cardioversion (ECV) in a patient with an active-fixation LP. The results suggest that ECV in these patients appears to be safe and feasible.