Key result
Transcatheter Micra retrieval succeeds in ~89% of patients without procedural adverse events.
Why the study?
While current recommendations advise abandoning the Micra transcatheter pacing system at the end of device life, catheter-based retrieval may be favorable in specific clinical scenarios.
Is transcatheter non-acute retrieval of a tine-based leadless ventricular pacemaker safe and feasible in patients requiring device removal or exchange?
Observational (n=9)
No
Is transcatheter non-acute retrieval of a tine-based leadless ventricular pacemaker safe and feasible in patients requiring device removal or exchange?
Transvenous late retrieval of implanted tine-based leadless pacemakers is safe and feasible, offering a practical alternative to the standard practice of device abandonment at the end of battery life.
Answers are grounded in this paper and cite their sources.
Supports feasibility of non-acute retrieval in select patients; leaves open need for larger studies before broader adoption.
AIMS: We report our single-centre experience of mid-term to long-term retrieval and reimplantation of a tine-based leadless pacemaker [Micra transcatheter pacing system (TPS)]. The TPS is a clinically effective alternative to transvenous single-chamber ventricular pacemakers. Whereas it is currently recommended to abandon the TPS at the end of device life, catheter-based retrieval may be favourable in specific scenarios. METHODS AND RESULTS: We report on nine consecutive patients with the implanted TPS who subsequently underwent transcatheter retrieval attempts. The retrieval system consists of the original TPS delivery catheter and an off-the-shelf single-loop 7 mm snare. The procedure was guided by fluoroscopy and intracardiac echocardiography. After an implantation duration of 3.1 ± 2.8 years (range 0.4-9.0), the overall retrieval success rate was 88.9% (8 of 9 patients). The mean procedure time was 89 ± 16 min, and the fluoroscopy time was 18.0 ± 6.6 min. No procedure-related adverse device events occurred. In the one unsuccessful retrieval, intracardiac echocardiography revealed that the TPS was partially embedded in the ventricular tissue surrounding the leadless pacemaker body in the right ventricle. After retrieval, three patients were reimplanted with a new TPS device. All implantations were successful without complications. CONCLUSION: A series of transvenous late retrievals of implanted TPS devices demonstrated safety and feasibility, followed by elective replacement with a new leadless pacing device or conventional transvenous pacing system. This provides a viable end-of-life management alternative to simple abandonment of this leadless pacemaker.
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Funasako et al. (2024) conducted an observational in Patients with an implanted tine-based leadless pacemaker requiring retrieval (n=9). Transcatheter retrieval of the leadless pacemaker using the original delivery catheter and a 7 mm snare was evaluated on Overall retrieval success rate. Transcatheter retrieval of the Micra leadless pacemaker was successfully achieved in 88.9% (8 of 9) of patients without procedure-related adverse events.
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