Retrieval of Long-Term Implanted Leadless Pacemakers

• Published in: JACC. Clinical electrophysiology 2020-12, Vol.6 (14), p.1744-1751
• Main Authors: Minami, Kentaro, Neužil, Petr, Petrů, Jan, Chovanec, Milan, Hubbard, Chris, Hála, Pavel, Janotka, Marek, Škoda, Jan, Šedivá, Lucie, Reddy, Vivek Y.
• Format: Article
• Language: English
• Subjects: leadless cardiac pacemaker; Nanostim; pacemaker retrieval
• ISSN: 2405-500X; 2405-5018
• DOI: 10.1016/j.jacep.2020.06.010

The authors report their single-center experience with the retrieval and replacement of long-term implanted leadless cardiac pacemakers (LPs) and the factors contributing to success. LPs are a clinically effective and safe alternative to standard transvenous pacemakers for single-chamber ventricular pacing. However, the feasibility of retrieving and replacing long-term implanted LPs is not well known. A total of 34 patients with implanted Nanostim LPs (mean implantation duration 1,570 ± 479 days) subsequently underwent retrieval. On the basis of fluoroscopic imaging, the cohort was divided into 2 groups: those with remarkable swinging movement (SM) of the LP docking button (n = 25) and those without SM (n = 9). The overall LP retrieval success rate was 85% (n = 29). New leadless devices were implanted in 27 patients immediately after LP retrieval. No procedure-related adverse events occurred. The rate of successful LP retrieval was significantly higher in the SM group (25 of 25 [100%]) than in the no-SM group (4 of 9 [44%]) (p