Abstract
A 70-year-old man affected by a metastatic lung adenocarcinoma developed an atrioventricular block. Due to an extensive thrombosis of the superior vena cava with invasion of the right atrium, a traditional transvenous pacemaker system (TTPS) implantation was not feasible. Despite the extensive development of the thrombosis in the right atrium, the patient successfully underwent Micra transcatheter pacing system (MTPS) implantation.