The right pacemaker for the right patient: use of leadless pacing in the athlete

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Summary. Clinical report. A 43-year-old woman, a swimmer and tennis instructor, showed up with syncope and prolonged reflex asystole. Admitted to the Cardiology Department, she underwent transvenous left subclavian pacemaker (PMK) implantation. Three weeks later, she complained of edema in her left arm, with evidence of subclavian vein thrombosis, and was started on anticoagulant therapy. After the resolution of the thrombosis, she continued to complain of shoulder discomfort and pain when moving her arm, making it difficult to perform her daily tasks. Therefore, the generator and catheters were removed, and a leadless PMK was implanted. One month later, the patient reported complete recovery of arm mobility and was able to resume swimming without limitations after two months. Discussion. Sports in PMK recipients, although recommended, have limitations due to the underlying disease, dependence on pacing, and the risk of direct trauma. Leadless PMKs are completely intracardiac and offer a significant reduction in complications related to the surgical pocket or lead, a lower risk of infection, and potential direct trauma. The absence of a subcutaneous device offers greater freedom of joint movement, the absence of visible scarring, and a quicker return to activity.

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