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Pacing the Impossible: ICE- and Voltage-Guided Atrial Leadless Pacemaker Implantation in Double Mechanical Valve Disease

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A and B: Right atrial voltage mapping identified a limited region of viable myocardium within an extensive atrial scar. C: Intracardiac echocardiography guided safe deployment of an atrial leadless pacemaker. D and E: Fluoroscopy confirmed stable device positi... ...