Nanostim leadless pacemaker retrieval and simultaneous micra leadless pacemaker replacement: a single-center experience

Asirvatham, Roshini; Vaidya, Vaibhav R.; Thome, Trena; Friedman, Paul A.; Mei, Yong

doi:10.1007/s10840-019-00647-3

Cited by 7 publications

(10 citation statements)

References 18 publications

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“…described three Nanostim devices that were successfully removed at 983, 1048, and 1070 days 7 . At Mayo Clinic in Rochester, MN, eight Nanostim devices were retrieved between 480 and 615 days, and one device was left in when the retrieval feature on the device detached 9 . Curnis et al., 8 removed a Micra using the Micra delivery system and snare after 29 months, and Lakkireddy et al., 6 described 47 of 53 LP retrieval attempts being successful between 0.2 and 4 years after implant.…”

Section: Discussionmentioning

confidence: 99%

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Visual observation of extraction of a Micra leadless pacemaker from a human cadaver

Bonner

Hilpisch

Wika

et al. 2022

Pacing Clinical Electrophis

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Introduction In this article we present the extraction of a Micra from a human cadaver implanted 3 years previously with both visual and X‐ray imaging taken during the removal. Methods A Micra pacemaker was extracted from a human cadaver with endoscopy and fluoroscopy using a Micra delivery tool. Histological analysis was performed on slices from the tissue surrounding the Micra. Results The fully encapsulated Micra was easily retrieved with a maximum force of 1.9 pounds. Conclusions Even though the Micra was implanted almost 3 years previously, the snaring and extraction of the Micra was performed relatively easily and with minimal force required.

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Section: Discussionmentioning

confidence: 99%

“…The longest published implant time before successful retrieval is 4 years for Micra, 2 and 4 years for Nanostim 1 . There are only a small number of single center series and case reports of LP retrievals mostly within 1 year of implantation 3–13 …”

Section: Introductionmentioning

confidence: 99%

Visual observation of extraction of a Micra leadless pacemaker from a human cadaver

Bonner

Hilpisch

Wika

et al. 2022

Pacing Clinical Electrophis

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Leadless cardiac pacing has emerged as an attractive therapeutic alternative to conventional transvenous pacing systems that provide therapy for patients with bradyarrhythmia. 1,2 The safety of leadless pacemaker has been well demonstrated, 3,4 but there is little experience about how to implant and deliver leadless pacemaker in patients with giant right heart and valvular diseases. 5 Because of the severely enlarge right atrium accompanied with moderate to serve tricuspid regurgitation, the relative position of tricuspid valve and right ventricle was changed, which makes it difficult to manipulate the delivery system through the tricuspid valve and find the suitable RV pacing site.…”

Section: Discussionmentioning

confidence: 99%

Successful application of snare‐kissing‐catheter technique to implant leadless pacemaker in severely dilated right heart

Huang

Zhang

Pan

et al. 2021

Pacing Clinical Electrophis

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Implantation of leadless pacemaker is efficacy and safety compared with the traditional pacemaker in structurally normal hearts. However, delivery experience of leadless pacemaker in patients with severe right heart enlargement remains limited. We present the rare case of a patient with giant right heart and moderate to severe tricuspid regurgitation implanted with a leadless Micra transcatheter pacemaker system. The extension of the Micra delivery catheter can be improved by using a single‐loop snare on the catheter proximal to appropriate right ventricle (RV) pacing position. The snare‐kissing‐catheter technique can aid in successful deployment in the setting of challenging right heart enlargement.

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“…Another highlights the importance of preoperative assessment of the LP device and having the electrophysiology service on standby with alternative pacing options readily available [ 30 ]. For patients undergoing retrieval of an LP, use of heparin is advised, and the difficulty of retrieval largely depends on the device position compared to the varying degrees of fibrosis around the device [ 31 ].…”

Section: Next Stepsmentioning

confidence: 99%

Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management

Hames

Hayanga

Schmidt-Krings

et al. 2021

Case Reports in Anesthesiology

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Leadless cardiac pacemakers were developed to reduce complications associated with conventional transvenous pacemakers. While this technology is still relatively new, devices are increasingly being implanted. The perioperative management of patients with these devices has been underreported; we thus seek to add to the limited body of knowledge of perioperative management of patients with leadless cardiac pacemakers. An elderly female patient with a Micra VR transcatheter pacing system leadless cardiac pacemaker placed for tachycardia-bradycardia syndrome with intermittent complete heart block was scheduled for elective tricuspid valve replacement for severe tricuspid regurgitation. Pacemaker interrogation was performed several hours prior to the scheduled surgery based on the electrophysiologist’s availability; the device was kept in its programmed VVIR mode, and the base rate was increased from 60 to 80 beats per minute in anticipation of the upcoming surgery. Upon preoperative evaluation, the anesthesiologist asked that the electrophysiology team be placed on standby intraoperatively due to the concern that either oversensing in the setting of pacemaker dependence and/or undesirable tachycardia from rate-responsive pacing could occur. The surgeon used monopolar electrocautery for the duration of the cardiac surgery. Despite the patient having evidence of pacemaker dependence in the intensive care unit preoperatively, no electromagnetic interference leading to oversensing nor rate modulation was detected during intraoperative electrocardiographic and intraarterial invasive monitoring. Evidence-based guidelines regarding perioperative management specifically of leadless cardiac pacemakers do not exist. As these devices become more prevalent, further evaluation will be paramount to determine whether existing guidelines for perioperative management of conventional transvenous pacemakers apply.

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Nanostim leadless pacemaker retrieval and simultaneous micra leadless pacemaker replacement: a single-center experience

Cited by 7 publications

References 18 publications

Visual observation of extraction of a Micra leadless pacemaker from a human cadaver

Visual observation of extraction of a Micra leadless pacemaker from a human cadaver

Successful application of snare‐kissing‐catheter technique to implant leadless pacemaker in severely dilated right heart

Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management

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