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Recently receiving Food and Drug Administration approval, the AVEIR VR leadless pacemaker system provides a helix based active fixation leadless pacemaker system. This step\u2010by\u2010step review will cover patient selection, preprocedural planning, device implantation technique, implant site evaluation, troubleshooting, short\u2010 and long\u2010term complications as well as future directions for leadless pacing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected and reviewed cases from primary operators to provide a step\u2010by\u2010step review for implanters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our paper provides a guide to patient selection, pre\u2010procedural planning, device im plantation technique, implant site evaluation, troubleshooting, short\u2010 and long\u2010term complications as well as future directions for leadless pacing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The helix based active fixation leadless pacemaker system is a safe and efficacious way to provide pacing support to patients and provides an alternative to transvenous pacing systems. Our review provides a step\u2010by\u2010step guide to implantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15785","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T19:27:16Z","timestamp":1671650836000},"page":"748-759","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Leadless cardiac ventricular pacing using helix fixation: Step\u2010by\u2010step guide to implantation"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2779-3154","authenticated-orcid":false,"given":"Balint","family":"Laczay","sequence":"first","affiliation":[{"name":"Heart, Vascular, and Thoracic Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5032-1238","authenticated-orcid":false,"given":"Jose","family":"Aguilera","sequence":"additional","affiliation":[{"name":"Heart, 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