Key result
A dislocated Micra leadless pacemaker was successfully retrieved from the pulmonary artery using a single-loop retrieval snare and a steerable sheath.
Case Report (n=1)
A dislocated leadless pacemaker can be successfully retrieved using a conventional gooseneck snare and steerable sheath, providing a viable management strategy for this rare complication.
May guide management of rare leadless pacemaker dislocation; extends case reports but leaves open standardized protocols.
BACKGROUND: Leadless pacemakers (PMs) were recently introduced to address the complication rate of standard PMs with transvenous leads. METHODS AND RESULTS: A 34-year old male with a history of intravenous substance abuse and a chronic type C hepatitis developed a complete atrioventricular block after cardiac surgery for infective endocarditis. Repeatedly, endo- and epi-cardially implanted PMs had to be explanted due to infection. A leadless MICRA pacemaker was successfully implanted with a dislocation into pulmonary artery several days after implantation. The PM was successfully retrieved using a single-loop retrieval snare guided by a steerable sheath. Subsequently, another Micra PM was successfully implanted with no further issues. CONCLUSION: In the case of a Micra leadless pacemaker dislocation, a conventional gooseneck snare in combination with a steerable sheath can be used to retrieve the device, improving the overall safety of leadless pacemakers.
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Táborský et al. (2018) conducted a case report in Complete atrioventricular block, infective endocarditis, and repeated pacing system infections (n=1). Leadless pacemaker extraction using a single-loop retrieval snare and steerable sheath was evaluated on Successful retrieval of dislocated leadless pacemaker. A dislocated Micra leadless pacemaker was successfully retrieved from the pulmonary artery using a single-loop retrieval snare and a steerable sheath.
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