Key result
Implanting a third leadless pacemaker proves feasible when extraction risks are high.
Why the study?
Management of leadless pacemaker battery depletion in frail patients with complex cardiac histories and prior device infection presents unique challenges.
Case Report (n=1)
This case demonstrates the feasibility of implanting a third leadless pacemaker in frail patients with complex cardiac histories when extraction risks are prohibitively high.
Hypothesis-generating for repeated leadless pacing in high-extraction-risk patients; prospective data needed on long-term safety.
Leadless pacemakers (LPMs) offer an alternative for patients with challenging venous access or device infection history. Management of LPM battery depletion in frail patients presents unique challenges. We present the case of an 81-year-old frail woman with obstructive hypertrophic cardiomyopathy and complete heart block, previously treated with percutaneous transseptal myocardial ablation and a transvenous pacemaker, who received an LPM after device extraction for infection. On battery depletion, a second LPM was implanted but dislodged, thus necessitating extraction attempts. Given the high extraction risks, a third LPM was successfully implanted. This case highlights the feasibility of multiple LPM implantations in complex cardiac patients and demonstrates that a third LPM can be a viable option when extraction risks are high. This approach expands management options for frail patients with complex cardiac histories who are unsuitable candidates for traditional pacing systems.
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Yagasaki et al. (2024) conducted a case report in Obstructive hypertrophic cardiomyopathy and complete heart block (n=1). Leadless pacemaker implantation was evaluated on Successful implantation of a third leadless pacemaker. Implantation of a third leadless pacemaker was successfully performed in an 81-year-old woman, demonstrating a viable option when extraction risks are high.
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