Extraction of long-term tine-based leadless pacemakers through the jugular approach: two case reports

Background: Tine-based leadless pacemakers (LP) have been in clinical use for over a decade. However, optimal management at the time of battery depletion remains uncertain. In this report, we describe the successful extraction of two tine-based LP, performed 4 and 8 years after initial implantation, using a right internal jugular venous approach. Case summary: Two patients (86-year-old man and a 93-year-old woman) received their initial tine-based LP four and 8 years ago, respectively, for the prevention of severe bradycardia in the setting of permanent atrial fibrillation. Both underwent implantation of a new device due to battery depletion via a right jugular approach. After successful deployment, a steerable sheath and a Goose Neck Snare were used to retrieve the old device. This was successful in both cases and the previously implanted device could be extracted with little resistance. Conclusion: Retrieval of tine-based LP is possible and safe even after long-term implantation.