Safety of Implantation of a Leadless Pacemaker via Femoral Approach in the Presence of an Inferior Vena Cava Filter

: A 61-year-old woman with symptomatic complete heart block was referred for permanent pacemaker. The presence of a left-sided arteriovenous fistula and right-sided mastectomy with lymph node dissection precluded the implantation of a transvenous pacemaker, and therefore, a leadless pacemaker was recommended. The patient also had an inferior vena cava (IVC) filter. The passage of a 27-French introducer sheath housing the leadless pacemaker through IVC filter was carefully visualized under fluoroscopy and advanced to the right ventricle without any compromise to the filter. This case report shows the safety of passage of large sheaths via the IVC filter.