Successful Retrieval of a Dislodged Leadless Pacemaker from the Right Atrium

Area of Science:

• Cardiology
• Medical Devices
• Interventional Cardiology

Background:

• Leadless pacemakers are increasingly used for bradyarrhythmia.
• Device dislodgement during implantation is a rare but serious complication requiring retrieval.

Purpose of the Study:

• To report a case of leadless pacemaker dislodgement during implantation.
• To describe the successful retrieval of a dislodged leadless pacemaker from the right atrium.
• To highlight the advantages of right atrial migration for device retrieval.

Main Methods:

• A 91-year-old male with symptomatic complete atrioventricular block underwent leadless pacemaker implantation.
• The device dislodged into the right atrium after multiple failed right ventricular fixation attempts.
• A snare technique was employed for device retrieval from the right atrium.

Main Results:

• Successful retrieval of the dislodged leadless pacemaker using a snare within 115 minutes.
• The right atrial location facilitated easier snare capture due to reduced cardiac motion.
• No complications were noted on post-procedure imaging.

Conclusions:

• Unexpected migration of a leadless pacemaker to the right atrium can facilitate simpler and safer retrieval.
• Prompt recognition and management of device dislodgement are crucial.
• Understanding the implications of migration location is essential for managing complications.