Cross-Platform Retrieval of a Chronically Implanted Leadless Pacemaker Using a Dedicated Retrieval System

Figures

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  Figure 1. Positioning of the Aveir VR Leadless Pacemaker Fluoroscopic image demonstrating attempted positioning of the Aveir VR leadless pacemaker in the right ventricle in relation to the previously implanted Micra Transcatheter Pacing System. The Micra device is located in the mid-right ventricular septum, and the new device is positioned more apically to avoid device interaction. Sternal wires from prior cardiac surgery are visible. The prosthetic tricuspid valve ring is also seen, highlighting the anatomical constraint and rationale for a leadless pacing strategy.

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  Figure 2. Fluoroscopic Images Demonstrating Engagement of the Previously Implanted Micra Transcatheter Pacing System Using a Trilobed Snare System (A) The trilobed snare is advanced toward the proximal retrieval feature of the Micra device, with multiple attempts required to achieve optimal coaxial alignment for capture. (B) Successful engagement of the Micra device by the trilobed snare, with secure capture of the retrieval feature before recapture.

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  Figure 3. Retrieval of the Chronically Implanted Micra Device Fluoroscopic image demonstrating successful retrieval of the previously implanted Micra Transcatheter Pacing System, with complete removal of the device and preservation of a single leadless system following implantation of the Aveir VR leadless pacemaker.