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Comparison of the safety and efficacy of Nanostim and Micra transcatheter leadless pacemaker (LP) extractions: a multicenter experience

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Leadless pacemaker (LP) extraction is a relatively new field with limited operator experience. We sought to report a comparison of retrieval process for Nanostim vs Micra transcatheter LPs.

Methods

The list of retrievals for the Micra transcatheter pacemaker system (TPS) was obtained from Medtronic whereas Nanostim data was obtained from centers that participated in the Leadless II study. Details of retrieval such as indication, days post implantation, complications, and post procedure device management were obtained from the manufacturer database for each site, and any missing details were obtained from individual operators. Extractions performed on the same day were labeled as “Early” and thereafter were labeled as “Late.”

Results

A total of 113 retrievals were attempted (73 in Nanostim and 40 in Micra TPS). The most common reasons for retrieval were battery advisory and inadequate pacing threshold (n = 16) for Nanostim and Micra, respectively. Success rate in Nanostim group was around 90% (66/73) compared with 100% in Micra group (p = 0.049). Late retrieval occurred in 50% of Micra TPS cases (20/40) compared with 100% of Nanostim LP cases. Median time to extraction was 46 days for Micra TPS and 256 days for Nanostim LP (p < 0.001). Rate of serious adverse events with Nanostim extraction was 3% (n = 2/73).

Conclusion

Overall, LP extraction is feasible and safe to perform irrespective of the duration and type of the device.

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Acknowledgments

We thank the following clinician scientists for their work:

Vivek Y. Reddy MD1

Icahn School of Medicine at Mount Sinai, New York, USA

3Homolka Hospital, Prague, Czech Republic

Marc A. Miller MD1

Icahn School of Medicine at Mount Sinai, New York, USA

Reinoud E. Knops MD2

Amsterdam Medical Center, Amsterdam, The Netherlands

Petr Neuzil MD PhD3

Prague, Czech Republic

Pascal Defaye MD4,

CHU, Grenoble, France;

Werner Jung MD5

Schwarzwald Baar Klinikum, Villingen-Schwenningen, Germany

Rahul Doshi MD6

USC University Hospital, Los Angeles, USA

Mark Castellani MD7

Sparrow Research, Lansing, USA

Adam Strickberger MD8

Inova Fairfax Hospital, Fairfax, USA

Hardwin R. Mead MD9

Sequoia Hospital, Redwood City, USA

Harish Doppalapudi MD10

University of Alabama, Birmingham, USA

Dhanunjaya Lakkireddy MD11

University of Kansas Medical Center

Matthew Bennett MD12

Vancouver General Hospital, Vancouver, Canada

Srinivas Dukkipati MD1

Icahn School of Medicine at Mount Sinai, New York, USA

Johannes Sperzel MD13

Hospital Kerckhoff Klinik, Bad Nauheim, Germany

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Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Tawseef Dar

  2. The Kansas City Heart Rhythm Institute (KCHRI) ,Overland Park Regional Medical Center, HCA MidWest, 12200, W 106th street, Overland Park, KS, 662215, USA

    Krishna Akella, Ghulam Murtaza, Rakesh Gopinathannair & Dhanunjaya Lakkireddy

  3. Department of Cardiology, Garden City Hospital, Garden City, MI, USA

    Sharan Sharma

  4. Division of Cardiovascular Diseases, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Muhammad R. Afzal & John Hummel

  5. Department of Internal Medicine, Division of Cardiovascular Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Ralph Augostini

Authors
  1. Tawseef Dar
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  2. Krishna Akella
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  3. Ghulam Murtaza
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  4. Sharan Sharma
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  5. Muhammad R. Afzal
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  6. Rakesh Gopinathannair
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  7. Ralph Augostini
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  8. John Hummel
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  9. Dhanunjaya Lakkireddy
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Corresponding author

Correspondence to Dhanunjaya Lakkireddy.

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Conflict of interest

DL is a consultant to Johnson & Johnson, Abbott, Biotronik, Pfizer, and Boston Sci. RG is a consultant/speaker of Abbott Medical, Boston Scientific, Zoll Medical, Pfizer, Bristol Myers Squibb and a physician advisor of HealthTrust PG, Abiomed.

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Dar, T., Akella, K., Murtaza, G. et al. Comparison of the safety and efficacy of Nanostim and Micra transcatheter leadless pacemaker (LP) extractions: a multicenter experience. J Interv Card Electrophysiol 57, 133–140 (2020). https://doi.org/10.1007/s10840-019-00684-y

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  • DOI: https://doi.org/10.1007/s10840-019-00684-y

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