Key result
Leadless pacemaker deployment and retrieval linked to massive TR from anterior papillary muscle rupture.
Why the study?
Tricuspid regurgitation from mechanical interference after leadless pacemaker implantation is recognized, but specific mechanisms such as papillary muscle rupture during retrieval remain rare.
Case Report (n=1)
Highlights a rare but catastrophic complication of leadless pacemaker retrieval involving papillary muscle entrapment and rupture leading to severe tricuspid regurgitation.
Answers are grounded in this paper and cite their sources.
Warrants caution during leadless pacemaker retrieval; leaves open the need for prospective safety data.
Background Leadless pacemakers (LPMs) reduce complications associated with transvenous systems; however, tricuspid regurgitation (TR) caused by mechanical interference after LPM implantation has been reported. We describe a rare case of massive TR caused by papillary muscle rupture during LPM deployment and retrieval. Case summary An 86-year-old man presented with syncope due to complete atrioventricular block. Because of his advanced age and limited activities of daily living, a leadless pacemaker was selected. During deployment, anterior papillary muscle became entrapped between the delivery sheath and the leadless pacemaker while recapturing. Subsequent retrieval resulted in papillary muscle rupture leading severe TR. The patient later underwent transvenous pacemaker implantation and recovered with medical therapy. Discussion This case highlights a previously unreported mechanism of TR during LPM implantation—papillary muscle entrapment and rupture during device retrieval—which can lead to catastrophic tricuspid valve dysfunction.
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Tanemura et al. (2026) conducted a case report in Complete atrioventricular block (n=1). Leadless pacemaker deployment and retrieval was evaluated on Massive tricuspid regurgitation caused by papillary muscle rupture. Leadless pacemaker deployment and retrieval resulted in anterior papillary muscle entrapment and rupture, leading to massive tricuspid regurgitation.
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