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Case Reports
. 2020 Nov 18;2(14):2249-2252.
doi: 10.1016/j.jaccas.2020.09.019.

Successful Retrieval of a 4-Year-Old Micra Transcatheter Pacemaker System in a Patient With Leadless Biventricular Pacing Therapy

Kentaro Minami  1 , Jürgen Shtëmbari  1 , Jan Petrů  1 , Milan Chovanec  1 , Moritoshi Funasako  1 , Pavel Hála  1 , Marek Janotka  1 , Jan Škoda  1 , Lucie Šedivá  1 , Vivek Y Reddy  1   2 , Petr Neužil  1
Affiliations
Case Reports

Successful Retrieval of a 4-Year-Old Micra Transcatheter Pacemaker System in a Patient With Leadless Biventricular Pacing Therapy

Kentaro Minami et al. JACC Case Rep. .

Abstract

This is the first report of the management of a patient with cardiac resynchronization therapy using leadless biventricular pacing. Successful retrieval of a 4-year-old Micra transcatheter pacing system (TPS) and reimplantation of a new Micra TPS prevented device-to-device interactions from multiple pacing devices in the right ventricle. (Level of Difficulty: Advanced.).

Keywords: CRT, cardiac resynchronization therapy; LV, left ventricular; TPS, transcatheter pacing system; endocardial pacing system; leadless cardiac pacemaker; left ventricular; pacemaker retrieval.

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Conflict of interest statement

This work was supported by the Ministry of Health of the Czech Republic (DRO; NNH, 00023884). Dr. Reddy has been a consultant with Abbott, Axon, Biosense Webster, Biotronik, Boston Scientific, Cardiofocus, Cardionomics, CardioNXT/AFTx, EBR, Impulse Dynamics, and Medtronic; has been a consultant for and received equity from Acutus Medical, Affera, Apama Medical, Autonomix, Backbeat, BioSig, Circa Scientific, Corvia Medical, East End Medical, EPD, Epix Therapeutics, EpiEP, Eximo, Impulse Dynamics, Farapulse, Javelin, Keystone Heart, LuxCath, Medlumics, Middlepeak, Northwind, Surecor, Valcare, and VytronUS; and has received equity from Manual Surgical Sciences, Newpace. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Figure 1
Figure 1
Intracardiac Echocardiogram Imaging of the Micra Transcatheter Pacing System Courtesy of Medtronic, Minneapolis, Minnesota.
Figure 2
Figure 2
Fluoroscopic Views of Leadless Pacemaker Retrieval (A) The system’s distal cone is positioned at the proximal aspect of the device. After snare advancement, the catheter is deployed around the proximal retrieval feature of the Micra transcatheter pacing system (TPS). (B) The snare is engaged and locked around the retrieval feature the Micra TPS. (C and D) After engaging the snare, the distal cone is docked and crossed over the Micra TPS. (E) Tension on the snare along with countertraction from the distal cone results in the release of the tines from the myocardium, and the Micra TPS is withdrawn from the patient’s body. (F) Reimplantation of a new Micra TPS is performed immediately after retrieval. ∗Left ventricular electrode of WiSE (EBR Systems, Sunnyvale, California); †transmitter; §battery pack. AP = anteroposterior; RAO = right anterior oblique.
See this image and copyright information in PMC

References

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