Bilateral external iliac vein compression-An important consideration in implantation of leadless permanent pacemaker

Strategies to overcome complicated situations in leadless pacemaker implantation

Although leadless pacemaker implantation is not complicated, challenges exist in complex situations, which can be prevented and resolved with appropriate treatments including dealing with the abnormal venous access or choosing a superior vena cava approach, implanting at the septum rather than the apex, a snare assistant technique to deployment, assurance of solid fixation, and snaring dislodged device.