# CARTO UNIVU-Guided Micra Implantation in Ebstein Anomaly

## TL;DR

This paper describes a successful leadless pacemaker implantation in a patient with a rare heart defect using advanced mapping technologies.

## Contribution

The novel use of CARTO UNIVU navigation for Micra implantation in Ebstein anomaly is demonstrated.

## Key findings

- CARTO systems enabled precise pacemaker placement in a complex anatomical case.
- The patient remained symptom-free with stable pacing parameters at 6 months.
- Advanced technologies improve outcomes in challenging congenital heart conditions.

## Abstract

Ebstein anomaly (EA) is a rare congenital heart defect characterized by tricuspid valve malformation and severe tricuspid regurgitation. This poses challenges for conventional pacemaker implantation.

An 86-year-old man with EA, atrial fibrillation, complete atrioventricular block, and heart failure underwent Micra VR leadless pacemaker implantation. The right ventricular angiography was inadequate due to torrential tricuspid regurgitation, necessitating the use of advanced mapping technologies. CARTO electroanatomical mapping and CARTO UNIVU navigation systems facilitated precise placement in the midseptal apex. At 6 months, the pacing parameters remained stable, and the patient was symptom free.

This case illustrates how advanced mapping technologies combined with leadless pacemakers can address anatomical challenges in EA. It underscores the importance of integrating modern technologies for precise device placement and improved outcomes in complex congenital conditions.