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Published on: December 2, 2016
Tether Entrapment and Fracture Preventing Release and Redocking of a Helix-Fixation Atrial Leadless Pacemaker:
Shuhei Arai1, Takamasa Ishikawa1, Rimpei Ueno1
1Division of Cardiology, Department of Medicine, Showa Medical University School of Medicine, Tokyo, Japan.
Background:
Helix-fixation dual-chamber leadless pacemakers reliably provide bradycardia pacing, yet mechanical complexity of the delivery system can rarely lead to procedural failure.
Case Presentation:
During atrial leadless pacemaker implantation, resistance felt when transitioning to tether mode suggested tether entrapment within a damaged torque shaft, resulting in mechanical distortion or fracture and preventing both device release and redocking. A controlled bailout maneuver-advancing the protective sleeve near the helix and rotating the entire catheter system counterclockwise-enabled safe unscrewing and withdrawal without complications.
Conclusion:
This report describes a previously unreported tether-related malfunction and a practical maneuver for resolving this failure mechanism.
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