Utility of transesophageal echocardiography during implantation of leadless pacemaker in pediatric patients

Transcatheter leadless pacemakers (LP) eliminate pocket and lead-related complications associated with traditional transvenous pacing systems. The safety and efficacy of LP are well described in the adult population 1,2. Recently, pediatric studies have also found its use favorable in select patient populations 3. The LP is particularly useful in pediatric patients with transient or paroxysmal atrioventricular (AV) block and those with prolonged pauses leading to symptoms. Technical challenges unique to pediatric implantation include smaller patient size, smaller cardiac chamber size, proximity to the tricuspid (TV) and pulmonary valve (PV), and the need for adequate vein size of at least 9mm to safely accept the delivery system 4.