Skip to main content
SpringerLink
Log in

Nanostim leadless pacemaker retrieval and simultaneous micra leadless pacemaker replacement: a single-center experience

  • MULTIMEDIA REPORT
  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The leadless pacemaker (LP) is a promising new technology in pacing therapy that avoids a generator pocket and transvenous lead-related complications. However, extraction experience with simultaneous re-implant of a leadless device remains limited. We sought to study the outcomes of Nanostim LP retrieval and simultaneous reimplantation of Micra LP.

Methods

Patients undergoing retrieval of the Nanostim LP and receiving a Micra LP implant between 2016 and 2018 at Mayo Clinic (Rochester, MN) were studied. The procedural and outcome data were collected from the electronic medical record.

Results

Nine patients underwent attempted Nanostim LP retrieval and 6 of these simultaneously received a Micra LP reimplant. All retrievals were considered chronic due to implant durations of > 1 year. Extraction procedures were completed with a success rate of 89% and simultaneous reimplantations were performed successfully in all cases with no major complications. Newly implanted Micra LP device function was normal at follow-up. Factors such as duration of device implant and device positioning appeared to impact ease of extraction.

Conclusions

Retrieval of the Nanostim LP system and simultaneous replacement with an alternate Micra leadless device appears to be a feasible approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

LP:

Leadless pacemaker

References

  1. Lown B, Kosowsky BD. Artificial Cardiac Pacemakers. N Engl J Med. 1970;283:907–16.

    Article  CAS  Google Scholar 

  2. van Rees JB, de Bie MK, Thijssen J, Borleffs CJW, Schalij MJ, van Erven L. Implantation-Related Complications of Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy Devices: A Systematic Review of Randomized Clinical Trials. J Am Coll Cardiol. 2011;58:995–1000.

    Article  Google Scholar 

  3. Klug D, Balde M, Pavin D, Hidden-Lucet F, Clementy J, Sadoul N, et al. Risk Factors Related to Infections of Implanted Pacemakers and Cardioverter-Defibrillators: results of a Large Prospective Study. Circulation. 2007;116:1349–55.

  4. PETRI K, KAI N, ANTTI Y, JUHANI K, PASI K, JUHA L, et al. Venous Obstruction After Pacemaker Implantation. Pacing Clin Electrophysiol. 2007;30:199–206.

  5. WU KH. FRANK B, HENDRIK B, FRANK E, MONIKA S and WERNER P. Long-Term Complication Rates in Ventricular, Single Lead VDD, and Dual Chamber Pacing. Pacing Clin Electrophysiol. 2003;26:1961–9.

    Article  Google Scholar 

  6. Chew DS, Kuriachan V. Leadless cardiac pacemakers: present and the future. Curr Opin Cardiol. 2018;33:7–13.

    Article  Google Scholar 

  7. Miller MA, Neuzil P, Dukkipati SR, Reddy VY. Leadless Cardiac Pacemakers: Back to the Future. J Am Coll Cardiol. 2015;66:1179–89.

    Article  Google Scholar 

  8. Reddy VY, Exner DV, Cantillon DJ, Doshi R, Bunch TJ, Tomassoni GF, et al. Percutaneous Implantation of an Entirely Intracardiac Leadless Pacemaker. N Engl J Med. 2015;373:1125–35.

  9. Reynolds D, Duray GZ, Omar R, Soejima K, Neuzil P, Zhang S, et al. A Leadless Intracardiac Transcatheter Pacing System. N Engl J Med. 2016;374:533–41.

  10. Knops RE, Tjong FVY, Neuzil P, Sperzel J, Miller MA, Petru J, et al. Chronic Performance of a Leadless Cardiac Pacemaker: 1-Year Follow-Up of the LEADLESS Trial. J Am Coll Cardiol. 2015;65:1497–504.

  11. Duray GZ, Ritter P, El-Chami M, Narasimhan C, Omar R, Tolosana JM, et al. Long-term performance of a transcatheter pacing system: 12-Month results from the Micra Transcatheter Pacing Study. Heart Rhythm. 2017;14:702–9.

  12. Reddy VY, Knops RE, Sperzel J, Miller MA, Petru J, Simon J, et al. Kautzner J and Neuzil P. Results of the LEADLESS Trial. Circulation: Permanent Leadless Cardiac Pacing; 2014.

  13. Battery Malfunction for Nanostim Leadless Cardiac Pacemaker (LCP) Model Number S1DLCP [press release]. St. Jude Medical, 28 October 2016

  14. Elkin GV, Omar AR, Jorge SG, José MG. Leadless pacemaker extraction from a single-center perspective. Pacing Clin Electrophysiol. 2018;41:101–5.

    Article  Google Scholar 

  15. Reddy VY, Miller MA, Knops RE, Neuzil P, Defaye P, Jung W, et al. Retrieval of the Leadless Cardiac Pacemaker: A Multicenter Experience. Circulation Arrhythmia and Electrophysiology. 2016;9.

  16. Beurskens NEG, Tjong FVY, Quast A-FBE, Knops RE. Successful replacement of the longest worldwide in situ Nanostim leadless cardiac pacemaker for a Micra Transcatheter Pacing System. J Interv Card Electrophysiol. 2018;51:161–2.

    Article  Google Scholar 

  17. Lakkireddy D, Knops R, Atwater B, Neuzil P, Ip J, Gonzalez E, et al. A worldwide experience of the management of battery failures and chronic device retrieval of the Nanostim leadless pacemaker. Heart Rhythm. 2017;14:1756–63.

  18. Bracke FA, Meijer A, van Gelder LM. Pacemaker lead complications: when is extraction appropriate and what can we learn from published data? Heart. 2001;85:254–9.

    Article  CAS  Google Scholar 

  19. FRANK B, ALBERT M, BERRY VG. Extraction of Pacemaker and Implantable Cardioverter Defibrillator Leads: Patient and Lead Characteristics in Relation to the Requirement of Extraction Tools. Pacing Clin Electrophysiol. 2002;25:1037–40.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, 55902, USA

    Roshini S. Asirvatham, Vaibhav R. Vaidya, Trena M. Thome, Paul A. Friedman & Yong-Mei Cha

Authors
  1. Roshini S. Asirvatham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vaibhav R. Vaidya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Trena M. Thome
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul A. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yong-Mei Cha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yong-Mei Cha.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

Cine from patient #9 demonstrating Nanostim device present in the right ventricle. An EPT ablation catheter advanced through the retrieval catheter snare is present in the right ventricle. The retrieval catheter is being advanced to the right ventricle, using the EPT catheter as a rail. (MOV 1659 kb)

ESM 2

Docking button detachment noted after Nanostim device snared. (MOV 706 kb)

ESM 3

Capture of the Nanostim docking button using suction applied to a multipurpose angiography catheter advanced through a deflectable Agilis sheath. (MOV 4557 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Asirvatham, R.S., Vaidya, V.R., Thome, T.M. et al. Nanostim leadless pacemaker retrieval and simultaneous micra leadless pacemaker replacement: a single-center experience. J Interv Card Electrophysiol 57, 125–131 (2020). https://doi.org/10.1007/s10840-019-00647-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-019-00647-3

Keywords

Search

Navigation