Extraction of a Micra Transcatheter Pacing System: First-in-human experience

Karim, Saima; Abdelmessih, Medhat; Marieb, Mark; Reiner, Eric J.; Grubman, Eric

doi:10.1016/j.hrcr.2015.10.001

Cited by 40 publications

(33 citation statements)

References 2 publications

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“…Although techniques have been described, the optimal management of intravascular portions of an infected miniaturised CIED system (leadless pacemakers) is currently not well defined 23. Embolism a right-sided mobile echogenic mass to the pulmonary vasculature or paradoxical embolism through a patent foramen ovale to the cerebral circulation may result in undesirable consequences 24.…”

Section: Introductionmentioning

confidence: 99%

Contemporary management of cardiac implantable electronic device infection

DeSimone

Sohail

Mulpuru

2019

Heart

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Section: Introductionmentioning

confidence: 99%

Contemporary management of cardiac implantable electronic device infection

DeSimone

Sohail

Mulpuru

2019

Heart

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“…The absence of programmable VVT mode in the LPM software limits the upgrading options when it is required (Figure ). Extraction of the LPM before reimplantation of a conventional CRT device may be performed in the early months following LPM implantation, but requires a careful balance of potential benefits and risks …”

Section: Discussionmentioning

confidence: 99%

“…Extraction of the LPM before reimplantation of a conventional CRT device may be performed in the early months following LPM implantation, but requires a careful balance of potential benefits and risks. 13 Future improvements are necessary to simplify CRT in patients already implanted with an LPM. In patients with venous access issues, an entirely leadless CRT is already feasible.…”

Section: Case #3mentioning

confidence: 99%

How to upgrade a leadless pacemaker to cardiac resynchronization therapy

Lacour

Bisson

Bernard

et al. 2019

Cardiovasc electrophysiol

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Introduction We sought to develop an efficient method to upgrade pacing‐induced cardiomyopathy (PICM) patients from a leadless pacemaker (LPM) to cardiac resynchronization therapy. Methods and Results Three consecutive patients with chronic atrial fibrillation, implanted with an LPM, with permanent right ventricular pacing, and who developed left ventricular systolic dysfunction due to PICM, were included. A conventional biventricular pacemaker with two different coronary sinus leads, one used for left lateral ventricular pacing, one for early right ventricular sensing, was implanted. It was then synchronized with the LPM working as the right ventricular pacing lead to provide biventricular pacing. The upgrading technique was feasible in all cases, without any perioperative complication. All patients had an improved clinical status during follow‐up. Conclusion This new upgrading technique allows efficient cardiac resynchronization therapy in LPM patients while preventing tricuspid valve crossing and providing an increased battery longevity.

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“…Animal data at 28 months showed one of four devices fully encapsulated with the remaining three devices safely and successfully removed . In man, there is only one report of the Micra device being retrieved, which was only several weeks postimplant . As further clinical experience is gained, we will increase our understanding of optimizing patient selection and device management throughout its life cycle.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Anatomy Can Accommodate Multiple Micra Transcatheter Pacemakers

Omdahl

Eggen

Bonner

et al. 2016

Pacing and Clinical Electrophysiology

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BackgroundThe introduction of transcatheter pacemaker technology has the potential to significantly reduce if not eliminate a number of complications associated with a traditional leaded pacing system. However, this technology raises new questions regarding how to manage the device at end of service, the number of devices the right ventricle (RV) can accommodate, and what patient age is appropriate for this therapy. In this study, six human cadaver hearts and one reanimated human heart (not deemed viable for transplant) were each implanted with three Micra devices in traditional pacing locations via fluoroscopic imaging.MethodsA total of six human cadaver hearts were obtained from the University of Minnesota Anatomy Bequest Program; the seventh heart was a heart not deemed viable for transplant obtained from LifeSource and then reanimated using Visible Heart® methodologies. Each heart was implanted with multiple Micras using imaging and proper delivery tools; in these, the right ventricular volumes were measured and recorded. The hearts were subsequently dissected to view the right ventricular anatomies and the positions and spacing between devices.ResultsMultiple Micra devices could be placed in each heart in traditional, clinically accepted pacing implant locations within the RV and in each case without physical device interactions. This was true even in a human heart considered to be relatively small.ConclusionsAlthough this technology is new, it was demonstrated here that within the human heart's RV, three Micra devices could be accommodated within traditional pacing locations: with the potential in some, for even more.

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Extraction of a Micra Transcatheter Pacing System: First-in-human experience

Cited by 40 publications

References 2 publications

Contemporary management of cardiac implantable electronic device infection

Contemporary management of cardiac implantable electronic device infection

How to upgrade a leadless pacemaker to cardiac resynchronization therapy

Right Ventricular Anatomy Can Accommodate Multiple Micra Transcatheter Pacemakers

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