Leadless cardiac pacemaker

Last revised by Arlene Campos on 28 Aug 2024

Leadless cardiac pacemakers are a type of cardiac conduction device. These pacemakers are self-contained right ventricular single-chamber pacemakers that are implanted percutaneously via a femoral approach 1-3. There are two leadless cardiac pacemakers on the market: Nanostim™️ (Abbott Medical) and Micra™️ (Medtronic).

Radiographic features

A leadless cardiac pacemaker can be appreciated on plain chest radiographs or CT scans as a radiopaque oblong-shaped small device in the right ventricle 1-3. It is important to not mistake this device, especially on a PA view plain radiograph, for the similarly-shaped implantable loop recorder 2.

Depending on the brand, the exact size varies 1:

  • Nanostim™️ Leadless Cardiac Pacemaker (Nanostim™️ LCP): 4.2 cm x 0.6 cm

  • Micra™️ Transcatheter Pacing System (Micra™️ TPS): 2.6 cm x 0.7 cm

Both devices are compatible with 1.5 T and 3 T body MRI 4.

Differential diagnosis

Cases and figures

  • Case 1
  • Case 2
  • Case 3

Imaging differential diagnosis

  • Implantable loop recorder device
  • USB flash drive
  • Vaping e-cigarette
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