Transjugular intravenous leadless pacemaker implantation in pediatric patients: A case report and literature review.

Leadless pacemaker (LPM) implantation in pediatric patients is increasingly considered as an alternative to conventional pacemakers, especially when femoral venous access is not feasible. We present the case of a 7-year-old child with Mobitz type II second-degree atrioventricular block who successfully underwent LPM implantation via the right internal jugular vein due to inadequate femoral vein diameter. A comprehensive literature review was conducted to summarize the outcomes of internal jugular vein approach in children. The transjugular approach demonstrates several advantages, including suitability for larger sheaths, reduced vascular complications, shorter implantation path, stable mid-septal positioning, and faster recovery. Preoperative evaluation of venous anatomy and patient-specific factors is critical. Although pericardial effusion and sensing issues may occur, the internal jugular vein represents a safe and effective alternative for LPM implantation in selected pediatric patients when femoral access is contraindicated.