Implantation of a Leadless Pacemaker after Incomplete Transvenous Lead Extraction in a 90-Year-Old Pacemaker-Dependent Patient

Gerald Drożdż, Bruno Hrymniak, Bartosz Biel, Przemysław Skoczyński, Wiktoria Drożdż, Dorota Zyśko, Waldemar Banasiak and Dariusz Jagielski
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Gerald Drożdż: Department of General Internal Medicine, Kantonsspital Graubünden, 7000 Chur, Switzerland
Bruno Hrymniak: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Bartosz Biel: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Przemysław Skoczyński: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Wiktoria Drożdż: Department of General Internal Medicine, Kantonsspital Graubünden, 7000 Chur, Switzerland
Dorota Zyśko: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Waldemar Banasiak: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Dariusz Jagielski: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland

IJERPH, 2022, vol. 19, issue 10, 1-5

Abstract: Transluminal lead extraction (TLE) is a well-established procedure for the removal of damaged or infected pacing systems. Despite its high efficacy, the procedure is associated with significant risks, some of which may contribute to severe life-threatening complications. Herein, we present the case of a 90-year-old female who was 100% pacemaker-dependent (PM-dependent) and had ventricular lead fragmentation after the TLE procedure. In this elderly patient, after taking into account the whole clinical context—age, frailty syndrome, infection, and high peri- and postprocedural risks—we decided on MICRA VR implantation as well as leaving the remains of the ventricular lead in the right heart chambers. A Leadless pacemaker (LP) is an excellent alternative to PM-dependent individuals, in whom implantation of permanent transvenous PM is precluded due to multiple infectious and non-infectious issues.

Keywords: transluminal lead extraction; leadless pacemaker; MICRA VR (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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