Abstract
Leadless pacemaker implantation in a patient with severe right atrium dilation was unsuccessful using the conventional approach. The delivery system failed to gain sufficient backup force from the atrial wall and moved upward within the dilated atrium. To overcome this, the snare technique was employed. By securing the slightly distal portion of the top of the shaft curve, the pushing force was effectively transmitted to the tip of the system, creating a stable gooseneck shape for successful implantation.