How to Implant a Leadless Pacemaker With a Tine‐Based Fixation

Abstract

Leadless Implant Procedure. Two major studies have shown that leadless pacemakers are safe and effective for patients requiring right ventricular rate responsive pacing therapy. This positive result recently led to FDA approval of one of the available leadless pacing devices. While this new technology is promising, it requires a different skill set for safe implantation. In this article, we review in detail the different steps required for implantation of tine-based leadless pacemakers while providing tips and tricks to minimize

Incidence of Cardiac Perforation With Conventional and With Leadless Pacemaker Systems: A Systematic Review and Meta‐Analysis

“…Both the leadless systems are delivered from the femoral vein to the right ventricle through a relatively large guiding catheter (18 French for Nanostim, 23 French Micra). While the Micra device has a tine‐based fixation mechanism, the Nanostim is fixated using a helical screw . Whereas leadless PMs may eliminate pocket‐ and lead‐related complications, other potential safety issues such as device dislodgement and embolization, peripheral vascular problems, or increased thresholds requiring device retrieval need to be taken in consideration.…”

“…To avoid pocket‐ and lead‐related complications, 2 new leadless pacing systems were recently developed . As leadless PMs are implanted with a relatively large delivery catheter through the femoral vein, cardiac perforation remains a major safety concern of this new technique …”

Femoral extraction of transvenous leads and leadless pacemakers—A review of the data, tools, and procedural steps

“…Both rely on snaring the device via the proximal retrieval button. A Micra introducer system is placed into the right atrium using the standard technique described for Micra implantation . In the first method, the Micra delivery system is advanced into the RV, using two orthogonal X‐ray views, the cup is aligned as close to the Micra as possible and a 7 mm snare is advanced around the device.…”

Singular Novel Technology With Varied Techniques For Implementation

“…In this issue of the Journal of Cardiac Electrophysiology , El‐Chami et al . describe practical and well‐explained details of the technique to implant a leadless pacemaker.…”