First in Man Right Atrial Appendage Implantation of a Micra Leadless Pacemaker.

IntroductionPacemaker implantation can be challenging in patients with congenital heart disease.Methods and ResultsIn a patient with Ebstein disease and symptomatic sinus node dysfunction, despite multiple attempts, the Micra (R) pacemaker could not be implanted in the severely dilated right ventricle. In that context, and after iodine injection to confirm the appropriate location, the Micra (R) pacemaker was successfully implanted in the right appendage at the first attempt.ConclusionDespite the recent development of dedicated dual-chamber leadless pacemaker, to the best of our knowledge, this case is the first off-label Micra (R) implantation in a right appendage.