Successful implant of a leadless pacemaker with tine-based fixation next to an abandoned battery-depleted screw-in helix fixation leadless device

Successful implant of a leadless pacemaker with tine-based fixation next to an abandoned... 500 E.M. Ve ´gh et al. 15. Barold SS, Herweg B. Usefulness of the 12-lead electrocardiogram in the follow- 19. Sodi-Pallares D, Barbato E, Delmar A. Relationship between the intrinsic deflection and up of patients with cardiac resynchronization devices. Part I. Cardiol J 2011; subepicardial activation; an experimental study. Am Heart J 1950;39:387–96. 18:476–86. 20. Sweeney MO, van Bommel RJ, Schalij MJ, Borleffs CJ, Hellkamp AS, Bax JJ. 16. Bryant AR, Wilton SB, Lai MP, Exner DV. Association between QRS duration Analysis of ventricular activation using surface electrocardiography to predict left and outcome with cardiac resynchronization therapy: a systematic review and ventricular reverse volumetric remodeling during cardiac resynchronization ther- meta-analysis. J Electrocardiol 2013;46:147–55. apy. Circulation 2010;121:626–34. 17. Gervais R, Leclercq C, Shankar A, Jacobs S, Eiskjaer H, Johannessen A, et al. 21. Singh JP, Fan D, Heist EK, Alabiad CR, Taub C, Reddy V, et al. Left ventricular Surface electrocardiogram to predict outcome in candidates for cardiac resynch- lead electrical delay predicts response to cardiac resynchronization therapy. ronization therapy: a sub-analysis of the CARE-HF trial. Eur J Heart Failure Heart Rhythm 2006;3:1285–92. 2009;11:699–705. 22. Gold MR, Birgersdotter-Green U, Singh JP, Ellenbogen KA, Yu Y, Meyer TE, et al. 18. Gold MR, Thebault C, Linde C, Abraham WT, Gerritse B, Ghio S, et al. Effect The relationship between ventricular electrical delay and left ventricular remodel- of QRS duration and morphology on cardiac resynchronization therapy out- ling with cardiac resynchronization therapy. Eur Heart J 2011;32:2516–24. comes in mild heart failure: results from the Resynchronization Reverses 23. Bonakdar HR, Jorat MV, Fazelifar AF, Alizadeh A, Givtaj N, Sameie N, et al. Remodeling in Systolic Left Ventricular Dysfunction (REVERSE) study. Circulation Prediction of response to cardiac resynchronization therapy using simple elec- 2012;126:822–9. trocardiographic and echocardiographic tools. Europace 2009;11:1330–7. doi:10.1093/europace/eux232 EP CASE EXPRESS Online publish-ahead-of-print 9 August 2017 .................................................................................................................................................... Successful implant of a leadless pacemaker with tine-based fixation next to an abandoned battery-depleted screw-in helix fixation leadless device Werner Jung*, Gholamreza Sadeghzadeh, Sebastian Jackle, Birge Roggenbuck-Schwilk, Vlada Zvereva, and Johannes Kohler Department of Cardiology, Academic Teaching Hospital of the University of Freiburg, Schwarzwald-Baar Klinikum, Klinikstrasse 11, D-78052, Villingen-Schwenningen, Germany * Corresponding author. Tel: 149 7721 933001; fax: 149 7721 9393099. E-mail address: werner.jung@sbk-vs.de An 84-year old man was admitted with presyncope due to battery failure of a TM leadless pacemaker (Nanostim St. Jude Medical) which had been implanted for bradyarrhythmias in 2014. Based on the presence of an occlusion in the sub- TM clavian vein and the patient’s preferences a leadless pacemaker (Micra Medtronic) was chosen as replacement. As the patient had concerns about complications from an extraction procedure the replacement device was im- planted without extraction of the dysfunctional leadless pacemaker. Access was through the femoral vein using a 23-French introducer. The device was placed at the mid-septum of the right ventricle sufficiently distant from the previous de- vice to avoid mechanical device interaction. A pull-and-hold fixation test was performed under fluoroscopy, depicted in the figure in RAO (Figure A) and LAO (Figure B) views (abandoned device indicated by arrows), to ensure the leadless pacemaker was securely embedded in the myocardium. Excellent electrical par- ameters, and unaffected papillary muscles and tricuspid valve function were con- firmed at the time of implant and at 3 months follow-up. This represents the first published implantation of a leadless pacemaker in a human patient with an abandoned leadless device. The procedure presents an alternative to current options when battery depletion or failure occurs in leadless pacemakers. The full-length version of this report can be viewed at: http://www.escardio.org/ Guidelines-&-Education/E-learning/Clinical-cases/Electrophysiology/EP-Case- Reports. Conflict of interest: W.J. has received speaker and consultancy fees from St. Jude Medical, Medtronic, Boston Scientific and Biotronik. V C The Author(s) 2017. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/ 4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Downloaded from https://academic.oup.com/europace/article-abstract/20/3/500/4079893 by Ed 'DeepDyve' Gillespie user on 16 March 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Europace Oxford University Press

Successful implant of a leadless pacemaker with tine-based fixation next to an abandoned battery-depleted screw-in helix fixation leadless device

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Abstract

500 E.M. Ve ´gh et al. 15. Barold SS, Herweg B. Usefulness of the 12-lead electrocardiogram in the follow- 19. Sodi-Pallares D, Barbato E, Delmar A. Relationship between the intrinsic deflection and up of patients with cardiac resynchronization devices. Part I. Cardiol J 2011; subepicardial activation; an experimental study. Am Heart J 1950;39:387–96. 18:476–86. 20. Sweeney MO, van Bommel RJ, Schalij MJ, Borleffs CJ, Hellkamp AS, Bax JJ. 16. Bryant AR, Wilton SB, Lai MP, Exner DV. Association between QRS duration Analysis of ventricular activation using surface electrocardiography to predict left and outcome with cardiac resynchronization therapy: a systematic review and ventricular reverse volumetric remodeling during cardiac resynchronization ther- meta-analysis. J Electrocardiol 2013;46:147–55. apy. Circulation 2010;121:626–34. 17. Gervais R, Leclercq C, Shankar A, Jacobs S, Eiskjaer H, Johannessen A, et al. 21. Singh JP, Fan D, Heist EK, Alabiad CR, Taub C, Reddy V, et al. Left ventricular Surface electrocardiogram to predict outcome in candidates for cardiac resynch- lead electrical delay predicts response to cardiac resynchronization therapy. ronization therapy: a sub-analysis of the CARE-HF trial. Eur J Heart Failure Heart Rhythm 2006;3:1285–92. 2009;11:699–705. 22. Gold MR, Birgersdotter-Green U, Singh JP, Ellenbogen KA, Yu Y, Meyer TE, et al. 18. Gold MR, Thebault C, Linde C, Abraham WT, Gerritse B, Ghio S, et al. Effect The relationship between ventricular electrical delay and left ventricular remodel- of QRS duration and morphology on cardiac resynchronization therapy out- ling with cardiac resynchronization therapy. Eur Heart J 2011;32:2516–24. comes in mild heart failure: results from the Resynchronization Reverses 23. Bonakdar HR, Jorat MV, Fazelifar AF, Alizadeh A, Givtaj N, Sameie N, et al. Remodeling in Systolic Left Ventricular Dysfunction (REVERSE) study. Circulation Prediction of response to cardiac resynchronization therapy using simple elec- 2012;126:822–9. trocardiographic and echocardiographic tools. Europace 2009;11:1330–7. doi:10.1093/europace/eux232 EP CASE EXPRESS Online publish-ahead-of-print 9 August 2017 .................................................................................................................................................... Successful implant of a leadless pacemaker with tine-based fixation next to an abandoned battery-depleted screw-in helix fixation leadless device Werner Jung*, Gholamreza Sadeghzadeh, Sebastian Jackle, Birge Roggenbuck-Schwilk, Vlada Zvereva, and Johannes Kohler Department of Cardiology, Academic Teaching Hospital of the University of Freiburg, Schwarzwald-Baar Klinikum, Klinikstrasse 11, D-78052, Villingen-Schwenningen, Germany * Corresponding author. Tel: 149 7721 933001; fax: 149 7721 9393099. E-mail address: werner.jung@sbk-vs.de An 84-year old man was admitted with presyncope due to battery failure of a TM leadless pacemaker (Nanostim St. Jude Medical) which had been implanted for bradyarrhythmias in 2014. Based on the presence of an occlusion in the sub- TM clavian vein and the patient’s preferences a leadless pacemaker (Micra Medtronic) was chosen as replacement. As the patient had concerns about complications from an extraction procedure the replacement device was im- planted without extraction of the dysfunctional leadless pacemaker. Access was through the femoral vein using a 23-French introducer. The device was placed at the mid-septum of the right ventricle sufficiently distant from the previous de- vice to avoid mechanical device interaction. A pull-and-hold fixation test was performed under fluoroscopy, depicted in the figure in RAO (Figure A) and LAO (Figure B) views (abandoned device indicated by arrows), to ensure the leadless pacemaker was securely embedded in the myocardium. Excellent electrical par- ameters, and unaffected papillary muscles and tricuspid valve function were con- firmed at the time of implant and at 3 months follow-up. This represents the first published implantation of a leadless pacemaker in a human patient with an abandoned leadless device. The procedure presents an alternative to current options when battery depletion or failure occurs in leadless pacemakers. The full-length version of this report can be viewed at: http://www.escardio.org/ Guidelines-&-Education/E-learning/Clinical-cases/Electrophysiology/EP-Case- Reports. Conflict of interest: W.J. has received speaker and consultancy fees from St. Jude Medical, Medtronic, Boston Scientific and Biotronik. V C The Author(s) 2017. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/ 4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Downloaded from https://academic.oup.com/europace/article-abstract/20/3/500/4079893 by Ed 'DeepDyve' Gillespie user on 16 March 2018

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EuropaceOxford University Press

Published: Mar 1, 2018

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