Retrieval of the Leadless Cardiac Pacemaker

Leadless cardiac pacemakers (LPs) have emerged as a safe and effective alternative to conventional transvenous pacemakers for patients with an indication for single-chamber ventricular pacing. In 2 prospective studies with intermediate follow-up, leadless pacemakers exhibited high acute implantation success rates and stable pacing performance at 6 months. Despite these promising results, the ability to retrieve a chronically implanted leadless pacemaker is an important component of leadless pacemaker management. Instances where removal of a chronically implanted leadless pacemaker may be desirable, or even necessary, include elevations in pacing threshold, reductions in sensing amplitude, development of right ventricular pacing-mediated cardiomyopathy, infection (albeit, none were seen in the trials), and at the end of battery life. Although the feasibility of retrieval of leadless pacemakers has been demonstrated in animal models up to two and a half years, there are no systematic reports of the safety and feasibility of this approach in humans. Herein, we report the results of the acute retrieval (<6 weeks) and chronic retrieval (>6 weeks) of the Nanostim LP in patients who underwent device implantation as part of 3 prospective multicenter trials.