Potential compression neuropathy of the femoral nerve caused by the delivery sheath of a transcatheter leadless pacemaker

Currently, 2 manufacturers have introduced leadless pacemaker systems: the Micra Transcatheter Pacing System (Medtronic, Minneapolis, MN) and the Nanostim (Abbott, St. Paul, MN). Although their effectiveness and usefulness during short-term follow-up in humans were recently reported in a few studies,1, 2, 3, 4 lethal complications such as cardiac perforation and tamponade, deep venous thrombosis, and retroperitoneal hemorrhage occurred during the implantation procedures, and their safety over a longer follow-up period remains to be fully clarified. From the anatomical point of view, femoral nerve injuries related to the large-bore delivery system used during femoral venous access may be a potential complication. We present a patient who transiently suffered from intense tearing pain of the right thigh probably owing to compression of the L2 and L3 nerves by the large-bore delivery sheath used.