Micra transcatheter pacing system implantation via the right internal jugular vein: Preliminary results from a Polish multicenter registry

BACKGROUND: Leadless pacemaker implantation via the right internal jugular vein (RIJV) is an emerging alternative to the traditional femoral approach, offering favorable anatomical access and potential procedural advantages. AIMS: Our aim was to assess electrical performance, procedural efficiency and safety of Micra leadless pacemaker implantation via RIJV. METHODS: Thirty-five consecutive patients who underwent Micra transcatheter pacing system (TPS) implantation via RIJV at 7 clinical centers in Poland between November 2024 and November 2025 were included in this registry. Procedural safety and efficacy were assessed, and in-hospital as well as short-term follow-up electrical parameters were analyzed. RESULTS: Implantation success was achieved in 100% of cases. There were no significant changes in R-wave sensing (8.41 [2.45] vs. 9.20 [3.43] vs. 9.34 [3.60] mV; P = 0.45) or pacing threshold (0.5 [0.38-0.57] vs. 0.5 [0.38-0.63] vs. 0.5 [0.38-0.69] V; P = 0.25) between procedure, predischarge, and 1-3-month follow-up. Impedance showed a decrease tendency across all time points (680 [620-745] vs. 630 [590-690] vs. 570 [535-607.5] Ω; P = 0.06). No mild or severe acute or in-hospital complications related to the procedure were observed. CONCLUSIONS: Micra TPS implantation via the RIJV is a highly effective and safe alternative to femoral access when performed in experienced cardiology centers.