Techniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience

Muhammad R. Afzal, Emile G. Daoud, Ryan Cunnane, Siva Mulpuru, Alan Koay, Azlan Hussain, Razali Omar, Koh Kok Wei, Anish Amin, Gregory Kidwell, Nirav Patel, Charles Love, Michael Lloyd, Maciej Sterliński, Seth Goldbarg, Miguel A. Leal, James Gabriels, Apoor Patel, Ram Jadonath, Eric GrubmanGeorge Crossley, Chris Pepper, Dhanunjaya Lakkireddy, Toshimasa Okabe, John D. Hummel, Ralph S. Augostini

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. Objective: The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS. Methods: A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site. Results: Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73%) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1–95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals. Conclusion: Early retrieval of the Micra TPS is feasible and safe.

Original languageEnglish (US)
Pages (from-to)841-846
Number of pages6
JournalHeart Rhythm
Volume15
Issue number6
DOIs
StatePublished - Jun 1 2018

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Equipment and Supplies
Infection
Catheters
Databases
Technology

Keywords

  • Cardiac implantable electronic device
  • Elevated threshold
  • Leadless pacemaker
  • Micra transcatheter pacing system
  • Retrieval

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Techniques for successful early retrieval of the Micra transcatheter pacing system : A worldwide experience. / Afzal, Muhammad R.; Daoud, Emile G.; Cunnane, Ryan; Mulpuru, Siva; Koay, Alan; Hussain, Azlan; Omar, Razali; Wei, Koh Kok; Amin, Anish; Kidwell, Gregory; Patel, Nirav; Love, Charles; Lloyd, Michael; Sterliński, Maciej; Goldbarg, Seth; Leal, Miguel A.; Gabriels, James; Patel, Apoor; Jadonath, Ram; Grubman, Eric; Crossley, George; Pepper, Chris; Lakkireddy, Dhanunjaya; Okabe, Toshimasa; Hummel, John D.; Augostini, Ralph S.

In: Heart Rhythm, Vol. 15, No. 6, 01.06.2018, p. 841-846.

Research output: Contribution to journalArticle

Afzal, MR, Daoud, EG, Cunnane, R, Mulpuru, S, Koay, A, Hussain, A, Omar, R, Wei, KK, Amin, A, Kidwell, G, Patel, N, Love, C, Lloyd, M, Sterliński, M, Goldbarg, S, Leal, MA, Gabriels, J, Patel, A, Jadonath, R, Grubman, E, Crossley, G, Pepper, C, Lakkireddy, D, Okabe, T, Hummel, JD & Augostini, RS 2018, 'Techniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience', Heart Rhythm, vol. 15, no. 6, pp. 841-846. https://doi.org/10.1016/j.hrthm.2018.02.008
Afzal, Muhammad R. ; Daoud, Emile G. ; Cunnane, Ryan ; Mulpuru, Siva ; Koay, Alan ; Hussain, Azlan ; Omar, Razali ; Wei, Koh Kok ; Amin, Anish ; Kidwell, Gregory ; Patel, Nirav ; Love, Charles ; Lloyd, Michael ; Sterliński, Maciej ; Goldbarg, Seth ; Leal, Miguel A. ; Gabriels, James ; Patel, Apoor ; Jadonath, Ram ; Grubman, Eric ; Crossley, George ; Pepper, Chris ; Lakkireddy, Dhanunjaya ; Okabe, Toshimasa ; Hummel, John D. ; Augostini, Ralph S. / Techniques for successful early retrieval of the Micra transcatheter pacing system : A worldwide experience. In: Heart Rhythm. 2018 ; Vol. 15, No. 6. pp. 841-846.
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abstract = "Background: Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. Objective: The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS. Methods: A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site. Results: Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73{\%}) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1–95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals. Conclusion: Early retrieval of the Micra TPS is feasible and safe.",
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T2 - A worldwide experience

AU - Afzal, Muhammad R.

AU - Daoud, Emile G.

AU - Cunnane, Ryan

AU - Mulpuru, Siva

AU - Koay, Alan

AU - Hussain, Azlan

AU - Omar, Razali

AU - Wei, Koh Kok

AU - Amin, Anish

AU - Kidwell, Gregory

AU - Patel, Nirav

AU - Love, Charles

AU - Lloyd, Michael

AU - Sterliński, Maciej

AU - Goldbarg, Seth

AU - Leal, Miguel A.

AU - Gabriels, James

AU - Patel, Apoor

AU - Jadonath, Ram

AU - Grubman, Eric

AU - Crossley, George

AU - Pepper, Chris

AU - Lakkireddy, Dhanunjaya

AU - Okabe, Toshimasa

AU - Hummel, John D.

AU - Augostini, Ralph S.

PY - 2018/6/1

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N2 - Background: Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. Objective: The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS. Methods: A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site. Results: Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73%) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1–95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals. Conclusion: Early retrieval of the Micra TPS is feasible and safe.

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