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

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.