{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:39:18Z","timestamp":1780468758711,"version":"3.54.1"},"reference-count":12,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Severe obesity presents significant challenges in imaging and delivery of therapy, including pacemaker implant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Result<\/jats:title><jats:p>We present our experience implanting a leadless pacemaker (LP) in a severely obese man presenting with heart block. We describe our multidisciplinary approach using right internal jugular venous access and transesophageal imaging in lieu of fluoroscopy which failed to provide workable images in this instance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultrasound guided LP placement may have wider application in the midst of an ongoing obesity epidemic where fluoroscopy imaging is both limited and unsafe.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16403","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T05:34:05Z","timestamp":1723527245000},"page":"2067-2070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["All the king's men (and women): Fluoro\u2010less leadless pacemaker implant in a severely obese patient"],"prefix":"10.1111","volume":"35","author":[{"given":"Ato","family":"Howard","sequence":"first","affiliation":[{"name":"Division of Cardiac Electrophysiology, Heart and Vascular Institute University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob N.","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology, Heart and Vascular Institute University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Talha","family":"Ayub","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology, Heart and Vascular Institute University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuelkasem","family":"Ezeldeen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Whyte","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5461-7247","authenticated-orcid":false,"given":"N. 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