Retrieval of a Micra transcatheter pacing system in a heart with a preexisting lead

• Main Authors: Junji Morita, Masato Fukunaga, Kenichi Hiroshima, Michio Nagashima, Mizuki Miura, Kenji Ando
• Format: Article
• Language: English
• Published: Elsevier 2018-09-01
• Series: Indian Pacing and Electrophysiology Journal
• Online Access: http://www.sciencedirect.com/science/article/pii/S0972629218300457

We report the case of a 74-year-old man with a previously implanted pacemaker lead. He had undergone Medtronic™ Micra Transcatheter Pacing System (TPS, Medtronic plc, MN, USA) implantation because of lead fracture. We implanted a new TPS and retrieved the dislodged one. We used a multiple-loop snare (EN snare®) and an 8.5F steerable sheath (Agilis NXT; St. Jude Medical, St Paul, MN, USA). The TPS was obstructed by the chordae tendineae of the tricuspid valve and the pacemaker lead. We pushed the TPS to the apex site; this enabled us to move the TPS away from the chordae tendineae and pacemaker lead. The TPS body was caught in the inferior vena cava and was successfully retrieved. To our knowledge, this is the first case reporting TPS retrieval in a heart with preexisting lead. Keywords: Dislodgement, Transcatheter pacing system, TPS retrieval