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Techniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience.

Abstract：

BACKGROUND:Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. OBJECTIVE:The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS. METHODS:A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site. RESULTS:Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73%) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1-95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals. CONCLUSION:Early retrieval of the Micra TPS is feasible and safe.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Afzal MR,Daoud EG,Cunnane R,Mulpuru SK,Koay A,Hussain A,Omar R,Wei KK,Amin A,Kidwell G,Patel N,Love C,Lloyd M,Sterliński M,Goldbarg S,Leal MA,Gabriels J,Patel A,Jadonath R,Grubman E,Crossley G,Pepper C,Lakkire

doi

10.1016/j.hrthm.2018.02.008

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

841-846

issue

6

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(18)30103-6

journal_volume

15

pub_type

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