Key result
Dual-snare technique enables safe extraction of Micra AV pacemakers and subsequent upgrade to LBBP.
Why the study?
High burden right ventricular pacing from Micra AV implantation may induce pacing-induced cardiomyopathy, but mature experience in extracting Micra AV devices combined with an upgrade to left bundle branch pacing is lacking.
Is the dual-snare technique safe and effective for extracting a Micra AV leadless pacemaker and upgrading to LBBP in a patient with PICM?
Case Report (n=1)
Is the dual-snare technique safe and effective for extracting a Micra AV leadless pacemaker and upgrading to LBBP in a patient with PICM?
The dual-snare technique provides a feasible and safe strategy for extracting Micra AV leadless pacemakers to allow for LBBP upgrade in patients developing pacing-induced cardiomyopathy.
May enable Micra AV extraction for LBBP upgrade in PICM; leaves open need for prospective validation.
Pacing-induced cardiomyopathy (PICM) is an important cause of the left ventricular systolic disfuction in patients with chronic high-burden right ventricular pacing. Recent evidence suggests that an upgrade to Left bundle branch pacing (LBBP) may confer benefit in PICM. Leadless pacemakers (LPs), represented by the Micra AV device, are widely applied in the treatment of bradyarrhythmias due to their minimal trauma and low complication rates. However, high burden right ventricular pacing (RVP) from Micra AV implantion may still induce PICM, and there is a lack of mature experience in the extraction of Micra AV devices combined with LBBP upgrade. The case report aims to introduce a feasible strategy for Micra AV extraction and subsequent LBBP upgrade in patients with PICM. The dual-snare technique is a safe and effective method for minimally invasive extraction of Micra AV leadless pacemakers.
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Zhang et al. (2026) conducted a case report in Pacing-induced cardiomyopathy (PICM) (n=1). Micra AV extraction using dual-snare technique and LBBP upgrade was evaluated. The dual-snare technique provided a safe and effective method for minimally invasive extraction of Micra AV leadless pacemakers and subsequent upgrade to left bundle branch pacing.
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