Premature ventricular contraction–induced polymorphic ventricular tachycardia after leadless pacemaker implantation: A unique adverse effect of leadless pacing

Abstract

Key Teaching Points•Leadless pacemaker implantation will result in unique complications distinct from traditional device implantation. Ventricular arrhythmias arising following implantation of a leadless pacing system should be recognized as potentially secondary to the implant position of the device.•Leadless pacing systems have no ability to store ventricular high-rate electrograms. Episodes of ventricular high rates should raise concern for ventricular arrhythmias in these patients.•Extraction of leadless devices is safe and effective. An experienced extraction team should be available at centers implanting leadless pacing devices. •Leadless pacemaker implantation will result in unique complications distinct from traditional device implantation. Ventricular arrhythmias arising following implantation of a leadless pacing system should be recognized as potentially secondary to the implant position of the device.•Leadless pacing systems have no ability to store ventricular high-rate electrograms. Episodes of ventricular high rates should raise concern for ventricular arrhythmias in these patients.•Extraction of leadless devices is safe and effective. An experienced extraction team should be available at centers implanting leadless pacing devices.