# Unexpected Coronary Sinus Embolization of a Leadless Pacemaker due to Initial Device Failure: A Case Report

## TL;DR

A leadless pacemaker moved to the coronary sinus due to a device failure and was successfully removed using a special technique.

## Contribution

This case report presents a rare complication and its resolution during leadless pacemaker implantation.

## Key findings

- Device dislodgement occurred due to inner shaft damage and insufficient tine fixation.
- A double-snarer technique successfully retrieved the embolized pacemaker.
- The case emphasizes the need for careful deployment and assessment during implantation.

## Abstract

Leadless pacemakers reduce complications compared to transvenous systems, but device dislodgement and embolization can occur. We report an 81‐year‐old man with atrial fibrillation and bradycardia who underwent Micra implantation. Because of inner shaft damage and insufficient tine fixation, the device embolized into the coronary sinus. It was successfully retrieved using a double‐snare technique, and a new device was implanted. This case highlights the importance of meticulous deployment technique and thorough intraprocedural assessment of device attachment, as well as troubleshooting strategies for unexpected embolization.

A leadless pacemaker embolized into the coronary sinus due to initial device failure. The device was successfully retrieved using a double‐snare technique under fluoroscopic guidance.