Immediate retrieval of an astray leadless Micra pacemaker with double-snare in single sheath

An 85-year-old woman with chronic atrial fibrillation and complete heart block received a leadless Micra pacemaker. Shortly after implantation, the device dislodged, migrating between the tricuspid valve and right ventricular apex, causing nonsustained ventricular tachycardia. Using a double-snare technique through a single 23-French delivery sheath, the pacemaker was retrieved within 40 min without complications. This case underscores the rare but serious risk of leadless pacemaker dislodgement, emphasizing the need for prompt recognition and swift intervention. The double-snare approach proved effective, minimizing procedural time and trauma, which is critical for high-risk elderly patients. As leadless pacing gains traction, expertise in emergency retrieval techniques is vital for interventional cardiology and critical care settings.

The online version contains supplementary material available at 10.1007/s12055-025-02085-5.