Key result
Leadless pacemaker entrapment in the subvalvular apparatus causes severe TR requiring complex surgical extraction.
Why the study?
Evidence is mixed on whether leadless pacemakers reduce tricuspid valve dysfunction risk, and data regarding the feasibility and challenges of extraction are limited.
Case Report (n=1)
No
Leadless pacemakers carry a risk of long-term tricuspid valve dysfunction through mechanical impingement, and their late extraction may be complicated by fibrous encapsulation.
Subvalvular leadless pacemaker placement warrants caution for regurgitation; leaves open questions on extraction safety and true incidence.
The last decade has seen growing interest in leadless cardiac pacing systems. The appeal of leadless pacemaker (LP) implantation is potentially avoiding complications associated with conventional transvenous systems, such as infection, lead fracture, and tricuspid valve (TV) dysfunction.1 However, evidence to date has provided mixed results as to whether leadless systems do, in fact, reduce the risk of TV dysfunction.2,3 Furthermore, there are limited data regarding the feasibility and challenges associated with LP extraction.
No takes yet. Share an insight, caveat, or question.
Adams et al. (2024) conducted a case report in Tricuspid regurgitation and leadless pacemaker complication (n=1). Leadless pacemaker (Micra-AV) was evaluated on Tricuspid valve complication and device extraction feasibility. Leadless pacemaker implantation into the subvalvular apparatus caused severe tricuspid regurgitation, necessitating challenging surgical extraction due to fibrous encapsulation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: