71716 | Leadless Pacemaker Deployment Post-EVOQUE TTVR: Procedural Insights and Early Outcomes
Recommended Citation
Abdelhai O, Rangavajla G, Halboni A, Frisoli T, Zweig BM, Villablanca P, Parikh S, Engel Gonzalez P, Lee J, Jabri A, Ghoneem A, Dawdy J, O'Neill BP, O'Neill WW. 71716 | Leadless Pacemaker Deployment Post-EVOQUE TTVR: Procedural Insights and Early Outcomes. Struct Heart 2025; 9.
Document Type
Conference Proceeding
Publication Date
6-1-2025
Publication Title
Struct Heart
Abstract
Background: Conduction block post TTVR with the Evoque valve can be a challenging scenario. Micra™ leadless pacemakers are a valuable pacing option in these patients as they do not involve a lead passing across the freshly implanted valve. The outcomes of patients undergoing Micra implantation post TTVR with the Evoque valve are not well known. Methods: We reviewed patients who developed high-grade AV block after EVOQUE TTVR between February 2024 and February 2025 and underwent Micra implantation. Clinical data, procedural details, technical challenges, and 30-day outcomes were analyzed. Results: Ten patients underwent successful Micra implantation post-EVOQUE. Multiple deployment attempts (up to 5) were often needed due to right heart dilation, valve-related interference, or rotated anatomy (Figure 1). Final device positions included apical and high septal locations. Pacing parameters were acceptable in all cases, though two had borderline thresholds. At 30 days, most patients had trivial or mild tricuspid regurgitation. One device dislodgement required reimplantation, and one patient died within 48 hours post-implant. [Formula presented] Conclusion: Micra implantation after EVOQUE TTVR is feasible but technically challenging. Procedural complexity is driven by anatomic distortion and valve-related barriers, requiring individualized approaches. Despite these challenges, short-term outcomes were generally favorable.
Volume
9
