Author + information
- Received March 2, 2020
- Revision received June 4, 2020
- Accepted June 8, 2020
- Published online August 26, 2020.
- Kentaro Minami, MDa,
- Petr Neužil, MD, PhDa,∗ (, )
- Jan Petrů, MDa,
- Milan Chovanec, MDa,
- Chris Hubbard, MBAb,
- Pavel Hála, MDa,
- Marek Janotka, MDa,
- Jan Škoda, MDa,
- Lucie Šedivá, MD, PhDa and
- Vivek Y. Reddy, MDa,c
- aCardiology Department, Na Homolce Hospital, Prague, Czech Republic
- bAbbott, St. Paul, Minnesota
- cIcahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address for correspondence:
Dr. Petr Neužil, Cardiology Department, Na Homolce Hospital, Roentgenova 37/2, 15030, Prague 5, Czech Republic.
Objectives The authors report their single-center experience with the retrieval and replacement of long-term implanted leadless cardiac pacemakers (LPs) and the factors contributing to success.
Background LPs are a clinically effective and safe alternative to standard transvenous pacemakers for single-chamber ventricular pacing. However, the feasibility of retrieving and replacing long-term implanted LPs is not well known.
Methods A total of 34 patients with implanted Nanostim LPs (mean implantation duration 1,570 ± 479 days) subsequently underwent retrieval. On the basis of fluoroscopic imaging, the cohort was divided into 2 groups: those with remarkable swinging movement (SM) of the LP docking button (n = 25) and those without SM (n = 9).
Results The overall LP retrieval success rate was 85% (n = 29). New leadless devices were implanted in 27 patients immediately after LP retrieval. No procedure-related adverse events occurred. The rate of successful LP retrieval was significantly higher in the SM group (25 of 25 [100%]) than in the no-SM group (4 of 9 [44%]) (p < 0.001), and fluoroscopy time during the retrieval procedure was shorter in the SM group (12.7 ± 8.6 min) than in the no-SM group (45.6 ± 19 min) (p < 0.001).
Conclusions This study demonstrated the feasibility and safety of retrieval of long-term implanted LPs after a mean duration of 4 years. Retrieval was most successful in patients whose docking buttons exhibited significant SM.
This study was supported by the Ministry of Health, Czech Republic, DRO (NHH, 00023884). Drs. Neužil and Reddy have received grant support from Abbott (St. Jude Medical), the manufacturer of the Nanostim leadless pacemaker. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received March 2, 2020.
- Revision received June 4, 2020.
- Accepted June 8, 2020.
- 2020 American College of Cardiology Foundation
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