The number of transcatheter aortic valve replacements (TAVR) is increasing rapidly, with expanding indications for populations with lower surgical risks [ ]. TAVR can lead to conduction disturbances, mainly due to mechanical injury to bundle of HIS, necessitating permanent pacemaker implantation (PPI) in as many as 22.4 % of post-TAVR patients [ ]. Traditional transvenous pacemakers (PM) exhibit a complication rate of 8.2 % within the first 90 days [ ]. This rate could potentially be higher when considering the age and frailty of post-TAVR patients. The advent of leadless pacemaker technology presents a less invasive alternative with lower short- and long-term risks of complications and high implantation success rate [ ]. Advanced versions of leadless PM, specifically MICRA™ AV (Medtronic, Minneapolis, MN, United States), operating in VDD mode have been launched. These second-generation right ventricular (RV)-implanted devices use a three-axis accelerometer to sense atrial contractions, broadening their use to patients with atrioventricular block (AVB) whose sinus node is intact, while facilitating atrioventricular synchrony (AVS) 70 % to 90 % of the time [ ]. Leadless PM implantation after TAVR-related AVB has been shown to carry low complication rates and good chronic device performance. MICRA leadless PM, implanted via femoral vein access using a 23 French (F) deflectable MICRA delivery system through a 27 F sheath, delivers a 1.75-gram leadless pacemaker into the right ventricular which is fixed in place through four nitinol tines.