Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Extraction/Removal D-PO03 - Poster Session III (ID 48) Poster

D-PO03-099 - Long-term Implanted Micra Leadless Pacemaker: Principles And Strategies For Successful Extraction (ID 1103)

Disclosure
  P. Neuzil: Honoraria/Speaking/Consulting Fee - Abbott; Boston Scientific; Medtronic. Research (Contracted Grants for PIs and Named Investigators only) - EBR Systems; NewPace Ltd.

Abstract

Background: The MICRA™ TPS leadless pacemaker (LLP) designed for single chambre right ventricular pacing and up to date is the most frequent used leadless pacemaker worldwide. There is no any dedicated system designed for long-term implanted MICRA™ TPS retrieval.
Objective: To investigate potential for MICRA TPS elective retrieval we describe the optimal and safe techique which can be used to get successful LLP extractions.
Methods: Patients who were enrolled in multicenter Micra registry in our center and were indicated for elective exchange due to multiple reasons (battery depletion, device upgrade, valve surgery, increase of thresholds). To start retrieval attempt , the delivery catheter was used with implemented 7 mm snare (6Fr) through empty central lumen. After snaring the proximal knob, the method of contratraction was used. The procedure was done in the hybrid room with surgical back-up.
Results: Out of our 146 patients with chronically implanted MICRA™ TPS 7 patients underwent elective retrieval attempts with an 86% success rate (1 attempt failed to retrieve the device) and a 0% SAE rate. The primary indication for retrieval was a medical advisory. The primary reason for unsuccessful retrieval was an inability to snare the LLP probably due to tissue overgrowth, Average time since LLP implantation to successful retrieval procedure was 582± 261 days (max 1226 days). After snaring the proximal element, retrieval was always successful, regardless of time to explant.
Conclusion: Elective MICRA™ TPS retrieval procedure can be considered regardless of device position in the RV or time since LLP implantation. Applying the appropriate retrieval tooles needs to be considered.
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