{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T05:03:36Z","timestamp":1767157416848,"version":"3.48.0"},"reference-count":0,"publisher":"Instituto Nacional Cardovascular - Carlos Alberto Peschiera Carrillo","issue":"4","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Peru Cardiol Cir Cardiovasc"],"abstract":"<jats:p>We present the case of a 51-year-old male with non-ischemic dilated cardiomyopathy and complete atrioventricular block, who was previously implanted with a cardiac resynchronization therapy defibrillator. The patient developed signs of pocket infection with a high risk of extrusion. Partial system extraction was performed, followed by 14 days of intravenous antibiotic therapy. Due to a history of ventricular fibrillation and permanent pacing dependency, and in the absence of viable transvenous access, a sequential implantation strategy was adopted using a leadless pacemaker (Micra AV, Medtronic) and a subcutaneous implantable cardioverter-defibrillator (EMBLEM, Boston Scientific). Both procedures were completed without complications, and the patient showed favorable recovery, with effective pacing, no arrhythmic recurrences, and no signs of infection at the six-month follow-up. This case illustrates the feasibility of a fully leadless approach in high-risk patients with contraindications to conventional transvenous systems.<\/jats:p>","DOI":"10.47487\/apcyccv.v6i4.513","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:00:21Z","timestamp":1761973221000},"page":"239-244","source":"Crossref","is-referenced-by-count":0,"title":["Combined leadless pacing and subcutaneous defibrillation strategy in a high-risk patient: first case report from Peru"],"prefix":"10.47487","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0885-6763","authenticated-orcid":false,"given":"Alexis","family":"Vallejos-Barrientos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5084-6547","authenticated-orcid":false,"given":"Diego","family":"Davila-Flores","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3447-061X","authenticated-orcid":false,"given":"Richard","family":"Soto-Becerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-1376","authenticated-orcid":false,"given":"Mario","family":"Cabrera-Salda\u00f1a","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-8547","authenticated-orcid":false,"given":"Carolina","family":"Guevara-Caicedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8575-1596","authenticated-orcid":false,"given":"Ana Cecilia","family":"Gonzales-Luna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9548-4428","authenticated-orcid":false,"given":"\u00c1ngel","family":"Cueva-Parra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6153-6645","authenticated-orcid":false,"given":"Marisel","family":"Payano-Rojas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4485-9173","authenticated-orcid":false,"given":"P\u00edo","family":"Zelaya-Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"26947","published-online":{"date-parts":[[2025,10,18]]},"container-title":["Archivos Peruanos de Cardiolog\u00eda y Cirug\u00eda Cardiovascular"],"original-title":[],"link":[{"URL":"https:\/\/apcyccv.org.pe\/index.php\/apccc\/article\/download\/513\/703","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/apcyccv.org.pe\/index.php\/apccc\/article\/download\/513\/703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T05:00:41Z","timestamp":1767157241000},"score":1,"resource":{"primary":{"URL":"https:\/\/apcyccv.org.pe\/index.php\/apccc\/article\/view\/513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,18]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,29]]}},"URL":"https:\/\/doi.org\/10.47487\/apcyccv.v6i4.513","relation":{},"ISSN":["2708-7212"],"issn-type":[{"type":"electronic","value":"2708-7212"}],"subject":[],"published":{"date-parts":[[2025,10,18]]}}}