Leadless Pacemaker Deployment Post-EVOQUE TTVR: Procedural Insights and Early Outcomes

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Structural 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 postEVOQUE. 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. 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

Issue

Suppl 1

First Page

63

Comments

New York Valves: The Structural Heart Summit, June 25-27, 2025, New York, NY

Last Page

64

DOI

10.1016/j.shj.2025.100629

Link to Full Text

Share

COinS