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Leadless pacemaker extraction from a single-center perspective
Elkin González Villegas1, Omar Al Razzo1, Jorge Silvestre García1
1Cardiovascular Surgery Department, Hospital Universitario La Paz, Madrid, Spain.
Pacing and Clinical Electrophysiology : PACE
|December 2, 2017
Summary
Leadless pacemaker extraction is a safe and feasible procedure for managing devices at end-of-life. Utilizing manufacturer-provided tools ensures successful removal, though long-term data is needed to confirm sustained safety.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Leadless pacemakers offer advantages over conventional devices by eliminating lead-related complications.
- Management strategies for end-of-life (EOL) leadless pacemakers remain controversial.
- A clear strategy for EOL leadless pacemaker management, including safe extraction, is increasingly necessary.
Purpose of the Study:
- To evaluate the safety and feasibility of leadless pacemaker extraction.
- To assess the efficacy of manufacturer-provided retrieval tools for leadless pacemaker removal.
Main Methods:
- Three Nanostim leadless pacemakers were prophylactically extracted from patients due to battery depletion.
- Pre-extraction transesophageal 3D echocardiography assessed device mobility and endothelialization.
- The Nanostim Retrieval Catheter S1RSIN was used for device extraction.
Main Results:
- Complete extraction was achieved in all three patients.
- Extraction procedures were completed with relatively short fluoroscopic times (16, 19, and 12 minutes).
Conclusions:
- Leadless pacemaker extraction is a safe and feasible procedure when using appropriate manufacturer tools.
- A low threshold for extraction is recommended to minimize patient risk.
- Further long-term data is required to fully assess the safety and feasibility of leadless pacemaker extraction over extended periods.
