Leadless Pacemaker Therapy in Symptomatic Complete Heart Block: A Case Report

Cardiac implantable electronic device (CIED) infections pose a major challenge, especially in elderly patients with multiple comorbidities. We describe a 73-year-old woman with hypertension, bronchial asthma, and dyslipidemia who developed recurrent pacemaker site infections following dual-chamber permanent pacemaker implantation. Despite wound debridement and device relocation via the right internal jugular vein, she experienced reinfection and intermittent complete heart block. Coronary angiography revealed normal coronaries. Given her high risk and repeated device-related complications, a leadless pacemaker was implanted via the femoral approach. The procedure was uneventful, and she was discharged in stable condition with satisfactory pacing parameters. Leadless pacemakers, by eliminating transvenous leads and subcutaneous pockets, substantially reduce infection risk and reintervention rates. This case underscores the importance of individualized management and highlights leadless pacing as a safe, effective alternative in patients with recurrent CIED infections, offering improved outcomes and reduced morbidity in high-risk populations.