A 77-year-old patient, with permanent atrial fibrillation, underwent successful Micra transcatheter pacing system (MTPS) implantation. Once begun the pull-back of the tether, an increasing resistance was felt by the operator until complete blockage. A challenging recapture of MTPS into the delivery system was performed. The retrieved MTPS showed an indissoluble knot close to the docking button that blocked the running of the tether, and a long clot inside the delivery system. The new design of internal handle components of MTPS recently updated seems to favor clot formation. We suggest a reconsideration of the standard recommendations about delivery system flushing and design of the inner flushing tube system.

Troubleshooting in PM Leadless: How to manage an indissoluble knot

Morani, Giovanni;Bolzan, Bruna;Tomasi, Luca;Zimelli, Emma;Ribichini, Flavio Luciano
2019-01-01

Abstract

A 77-year-old patient, with permanent atrial fibrillation, underwent successful Micra transcatheter pacing system (MTPS) implantation. Once begun the pull-back of the tether, an increasing resistance was felt by the operator until complete blockage. A challenging recapture of MTPS into the delivery system was performed. The retrieved MTPS showed an indissoluble knot close to the docking button that blocked the running of the tether, and a long clot inside the delivery system. The new design of internal handle components of MTPS recently updated seems to favor clot formation. We suggest a reconsideration of the standard recommendations about delivery system flushing and design of the inner flushing tube system.
2019
MTPS retrieval; leadless pacemaker; micra; micra implantation; micra transcatheter pacing system
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1004727
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