AIMS: We report our single-centre experience of mid-term to long-term retrieval and reimplantation of a tine-based leadless pacemaker [Micra transcatheter pacing system (TPS)]. The TPS is a clinically effective alternative to transvenous single-chamber ventricular pacemakers. Whereas it is currently recommended to abandon the TPS at the end of device life, catheter-based retrieval may be favourable in specific scenarios. METHODS AND RESULTS: We report on nine consecutive patients with the implanted TPS who subsequently underwent transcatheter retrieval attempts. The retrieval system consists of the original TPS delivery catheter and an off-the-shelf single-loop 7 mm snare. The procedure was guided by fluoroscopy and intracardiac echocardiography. After an implantation duration of 3.1 ± 2.8 years (range 0.4-9.0), the overall retrieval success rate was 88.9% (8 of 9 patients). The mean procedure time was 89 ± 16 min, and the fluoroscopy time was 18.0 ± 6.6 min. No procedure-related adverse device events occurred. In the one unsuccessful retrieval, intracardiac echocardiography revealed that the TPS was partially embedded in the ventricular tissue surrounding the leadless pacemaker body in the right ventricle. After retrieval, three patients were reimplanted with a new TPS device. All implantations were successful without complications. CONCLUSION: A series of transvenous late retrievals of implanted TPS devices demonstrated safety and feasibility, followed by elective replacement with a new leadless pacing device or conventional transvenous pacing system. This provides a viable end-of-life management alternative to simple abandonment of this leadless pacemaker.

• Keywords
• Leadless cardiac pacemaker, Leadless pacemaker reimplantation, Leadless pacemaker retrieval, Micra transcatheter pacing system,
• MeSH
• Time Factors MeSH
• Equipment Design MeSH
• Echocardiography MeSH
• Radiography, Interventional MeSH
• Cardiac Pacing, Artificial methods   MeSH
• Pacemaker, Artificial * MeSH
• Middle Aged MeSH
• Humans MeSH
• Device Removal * methods   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Cardiac Catheterization * methods   instrumentation   MeSH
• Cardiac Catheters MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• Keywords
• Atrial fibrillation, Bradycardia, Leadless cardiac pacemaker, Pacemaker complications, Pacemaker retrieval,
• Publication type
• Journal Article MeSH
• Case Reports MeSH

• Keywords
• Chronic implant, Device retrieval, Helix fixation, Leadless pacemaker, Single-chamber pacing,
• Publication type
• Journal Article MeSH
• Case Reports MeSH