EMBOLIZATION OF LEADLESS PACEMAKER INTO THE PULMONARY ARTERY
Recommended Citation
Shaik A, Khan A, Elshaer A, Hariri M, Adi MB, Yousif M. EMBOLIZATION OF LEADLESS PACEMAKER INTO THE PULMONARY ARTERY. J Am Coll Cardiol 2025; 85(12):3999.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Am Coll Cardiol
Keywords
artificial embolization, atrial fibrillation, bradycardia, case report, complete heart block, complication, conference abstract, electrocardiography, female, follow up, heart rate, heart ventricle pacing, human, leadless pacemaker, pulmonary artery, reimplantation, thorax radiography
Abstract
Background: Leadless pacemakers (LPs) are increasingly utilized in patients for ventricular pacing due to their low complication rates. However, embolization of device remains a concern, especially when it migrates to pulmonary artery (PA). Case A 74-year-old female with recent AV nodal ablation and LP placement for atrial fibrillation was sent for bradycardia from the clinic during a routine follow-up. Upon arrival, she was asymptomatic with a heart rate in the 40s, otherwise vitally stable. EKG revealed a complete heart block while chest x-ray confirmed LP dislodgement in the left middle PA (a). Percutaneous retrieval was performed successfully after several tries using a snare (b). An alternate LP was implanted without complication, and patient was discharged uneventfully. [Formula presented] Decision-making Due to LP embolization into PA in the setting of recent nodal ablation, decision was made to retrieve and implant a new device. The retrieval was complex as the docking button of device was not accessible initially. Repeated attempts were made using snares culminating in a successful extraction. Reimplantation of new device was uneventful and patient was subsequently discharged without complications. Conclusion Retrieval of LP in PA presents with challenges and novelty as only a handful of such cases are documented in literature. When determining the appropriate treatment approach, the likelihood of device re-dislodgement should be carefully considered versus risk of a pulmonary artery tear during retrieval.
Volume
85
Issue
12
First Page
3999
