{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:57:48Z","timestamp":1791219468817,"version":"4.1.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Mirror-image dextrocardia combined with absence of the hepatic segment of the inferior vena cava (IVC) and continuation of the azygos vein represents an extremely rare dual anatomical variation that significantly increases the technical complexity of leadless pacemaker (LP) implantation. This paper presents a 28-year-old male patient who required permanent pacing therapy due to third-degree atrioventricular block. Preoperative computed tomography angiography (CTA) clearly identified the aforementioned malformations. A Micra AV leadless pacemaker was subsequently implanted successfully via the left internal jugular vein. During the procedure, image mirroring technology was employed to assist the operation, ensuring precise deployment and stable parameters. This case marks the world's first successful LP implantation via the internal jugular vein in a patient with such complex anatomical variations, offering a novel, safe, and feasible approach for similar patients.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1701484","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:37:16Z","timestamp":1767595036000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A case report of successful implantation of a leadless pacemaker via the left internal jugular vein in a patient with mirror-image dextrocardia and absence of the inferior vena cava\u2019s hepatic segment"],"prefix":"10.3389","volume":"12","author":[{"given":"Yue","family":"Bao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"B1","first-page":"43","article-title":"Transvenous permanent pacemaker implantation in 13 patients with dextrocardia","volume":"36","author":"Gu","year":"2021","journal-title":"Chin Circ J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/pace.14579","article-title":"Leadless pacemaker implantation in dextrocardia with situs viscerum inversus: a case report and literature review","volume":"46","author":"Bontempi","year":"2023","journal-title":"Pacing Clin Electrophysiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1093\/europace\/euab232","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"24","author":"Glikson","year":"2022","journal-title":"Europace"},{"key":"B4","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/europace\/euy274","article-title":"Leadless pacemaker implantation via azygos vein in a patient with absence of the hepatic segment of the inferior vena cava","volume":"21","author":"Oliveira","year":"2019","journal-title":"Europace"},{"key":"B5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12872-025-04511-3","article-title":"Leadless pacemaker implantation in a patient with congenital azygos continuation of the inferior vena cava","volume":"25","author":"Guo","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"key":"B6","first-page":"e382","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines and the heart rhythm society","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1002\/ccr3.1532","article-title":"Leadless pacemaker implantation after transcatheter lead extraction in complex anatomy patient","volume":"6","author":"De Regibus","year":"2018","journal-title":"Clin Case Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.4022\/jafib.1542","article-title":"Rescue leadless pacemaker implantation in a pacemaker-dependent patient with congenital heart disease and no alternative routes for pacing","volume":"9","author":"Sanhoury","year":"2017","journal-title":"J Atr Fibrillation"},{"key":"B9","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.ijcard.2016.01.099","article-title":"\u201cLeadless\u201d pacing of the left ventricle in adult congenital heart disease","volume":"209","author":"Wilson","year":"2016","journal-title":"Int J Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1136\/hrt.2007.132779","article-title":"The right ventricle: anatomy, physiology and clinical imaging","volume":"94","author":"Sheehan","year":"2008","journal-title":"Heart"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1701484\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:37:17Z","timestamp":1767595037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1701484\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":10,"alternative-id":["10.3389\/fcvm.2025.1701484"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1701484","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"article-number":"1701484"}}