Outcomes of tine-based leadless pacemakers retrieval: a multicenter study

Abstract

Abstract Background Leadless cardiac pacemakers (LCP) are well established in daily practice and comparable in safety as well as efficacy to conventional transvenous pacemakers. With increasing implant volumes, more patients may need extraction and retrieval of these devices. Data on extractability of LCPs is however scare. Purpose The aim of this study is to analyze indication, techniques, efficacy and safety of LCP extractions in a multicenter international registry. Methods This is an international, multicenter retrospective registry. Demographic parameters, indication of LCP extraction, success and complication rate were analyzed. Results A total of 50 patients (median age 71 years (IQR 64-81), 34% female) were included in this study. 52% of patients received the LCP for complete AV block. The primary underlying cardiac condition was coronary artery disease in 42%. The main indication for LCP extraction was rise in threshold with loss of capture (32%), upgrade to biventricular pacemaker (26%) or upgrade to transvenous dual-chamber device (14%) (Figure 1). The overall success rate of device extraction was 96% with a mean dwell time of the LCP of 715 days (range 0-1477 days). In most cases, a steerable sheath with a single loop snare (71%) was used (Figure 2). Procedure related adverse events were low and included two pericardial effusion (not requiring any intervention) and one case of a device embolization that was retrieved successfully in the same setting. Overall mortality at 7 days was 0 %. Conclusion Retrieval/extraction of chronically implanted LCP appear to be safe and feasible in centers with expertise in femoral snaring.Indication for LCP retrievalTools used for LCP extraction