Extraction of Micra Leadless Pacemaker and Upgradation of Pacing-Induced Cardiomyopathy: A Case Report

Ying Zhang, Ke Li, Ao Li Chen, Min Li, Wei Yang, Xueying Chen* and Zongjun Liu*

Department of Cardiology, The Shanghai Putuo District Central Hospital, Hospital of Shanghai University of Traditional Chinese Medicine, China Department of Cardiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Centre for Interventional Medicine, Shanghai, China Both authors equally contributed to the study

^*Correspondance to: Xueying Chen and Zhongjun Liu 

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Abstract:

Pacing-induced cardiomyopathy (PICM) has been reported to be a major contributor to decreased left ventricular ejection fraction in patients with chronic high-burden right ventricular pacing. Unlike transvenous pacemakers (TVPS), leadless pacemakers (LPs) are associated with a lower risk of PICM. Recent evidence suggests that an upgrade to cardiac resynchronization therapy defibrillator (CRT-D) may prevent the occurrence of PICM. In recent years, the LP has been optimized to a form CRT-D, but whether its removal is necessary has not been clarified. In China, few studies have documented the removal and retrieval of LP, and there is no consensus regarding the appropriate extraction methods. Here, we present a case report describing the upgrade of a LP to a CRT-D while concurrently removing the existing LP. Our case offers a novel technique for LP extraction utilizing two steerable introducers.

Keywords:

Leadless pacer, Micra, Case report, PICM, CRTD

Cite the Article:

Zhang Y, Li K, Li Chen A, Li M, Yang W, Chen X, et al. Extraction of Micra Leadless Pacemaker and Upgradation of Pacing-Induced Cardiomyopathy: A Case Report. Ann Clin Case Rep. 2025; 10: 2719..