Extraction of a dislocated leadless pacemaker in a patient with infective endocarditis and repeated endocardial and epicardial pacing system infections

Abstract

Background: Leadless pacemakers (PMs) were recently introduced to address the complication rate of standard PMs with transvenous leads. Methods and Results: A 34-year old male with a history of intravenous substance abuse and a chronic type C hepatitis developed a complete atrioventricular block after cardiac surgery for infective endocarditis. Repeatedly, endo- and epi-cardially implanted PMs had to be explanted due to infection. A leadless MICRA pacemaker was successfully implanted with a dislocation into pulmonary artery several days after implantation. The PM was successfully retrieved using a single-loop retrieval snare guided by a steerable sheath. Subsequently, another Micra PM was successfully implanted with no further issues. Conclusion: In the case of a Micra leadless pacemaker dislocation, a conventional gooseneck snare in combination with a steerable sheath can be used to retrieve the device, improving the overall safety of leadless pacemakers.

Keywords

• micra
• leadless
• pacemaker
• dislocation
• extraction
• gooseneck snare