JACC. Case reports · 2026
Torque Transmission Failure During Leadless Pacemaker Implantation Caused by Severe Iliofemoral Venous Tortuosity.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kobashi Soichiro, Kimura Tomonari, Watanabe Atsuyuki
Аннотация
BACKGROUND: Leadless pacemakers have demonstrated safety and efficacy comparable to those of conventional transvenou s systems. However, anatomical abnormalities of the venous system may occasionally complicate implantation. We report a case of unsuccessful implantation of the Aveir VR leadless pacemaker caused by severe iliofemoral venous tortuosity resulting in failure of rotational torque transmission.
CASE SUMMARY: An 88-year-old woman developed sinus node dysfunction following catheter ablation for atrial tachycardia and underwent leadless pacemaker implantation. Although the delivery catheter successfully reached the right ventricle, severe tortuosity extending from the left femoral vein to the inferior vena cava prevented effective transmission of rotational force to the distal fixation helix. Bench simulation reproduced this phenomenon, demonstrating preserved torque transmission under mild tortuosity but marked attenuation under severe 3-dimensional tortuosity.
DISCUSSION: This case highlights a previously underrecognized mechanical limitation of active-fixation leadless pacemaker systems and underscores the importance of preprocedural assessment of venous anatomy.
CASE SUMMARY: An 88-year-old woman developed sinus node dysfunction following catheter ablation for atrial tachycardia and underwent leadless pacemaker implantation. Although the delivery catheter successfully reached the right ventricle, severe tortuosity extending from the left femoral vein to the inferior vena cava prevented effective transmission of rotational force to the distal fixation helix. Bench simulation reproduced this phenomenon, demonstrating preserved torque transmission under mild tortuosity but marked attenuation under severe 3-dimensional tortuosity.
DISCUSSION: This case highlights a previously underrecognized mechanical limitation of active-fixation leadless pacemaker systems and underscores the importance of preprocedural assessment of venous anatomy.