Second Micra leadless pacemaker implantation by using intracardiac echocardiography

Area of Science:

• Cardiology and Cardiac Electrophysiology
• Medical Device Technology
• Diagnostic Imaging

Background:

• The strategy for managing battery depletion in the Micra leadless pacemaker system requires further definition.
• Concerns exist regarding the mechanical interaction and optimal positioning for a second Micra device implantation.

Observation:

• A patient presented with a depleted Micra leadless pacemaker requiring a second implantation.
• Intracardiac echo (ICE) was utilized to guide the placement of the second Micra device.

Findings:

• Successful implantation of a second Micra leadless pacemaker was achieved following the depletion of the first.
• Intracardiac echo proved to be an effective tool for confirming the precise location of the second Micra implantation.

Implications:

• This case demonstrates a viable strategy for Micra leadless pacemaker replacement after battery depletion.
• Intracardiac echo guidance can mitigate concerns regarding device interaction and ensure optimal placement of a second Micra.
• Further studies are warranted to establish standardized protocols for leadless pacemaker replacement.