ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Removal of tine-based leadless pacemakers: insights from a large multicentre experience.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsAs implantation rates of leadless pacemakers (LPM) increase, a growing number of patients will require assessment of LPM removability. This multicentre study investigated the safety and feasibility of removal of tine-based LPMs. METHODS AND
resultsWe retrospectively analysed consecutive patients who underwent tine-based LPM removal between March 2016 and January 2024 across 11 centres in Europe and the USA. Demographic characteristics, indication for LPM removal, procedural success, and complication rates were assessed. A total of 85 patients [median age 73 years (IQR 64-82)] were included. Indications for LPM removal included temporary use after transvenous lead extraction (23.5%), upgrade to a biventricular pacing system (22.4%) or a transvenous dual-chamber pacemaker (9.4%), and increased pacing thresholds (21.2%). The median device dwell time was 96 days (IQR 29-320 days), and the overall procedural success rate was 96.5%. In the majority of cases, removal was performed using a steerable sheath in combination with a single-loop snare. Procedure-related adverse events occurred in 5.9% of patients, including two pericardial effusions and three cases of device embolization. Significant predictors of removal failure (n = 3, 3.5%) were apical device position [odds ratio (OR) 61.8.0; 95% confidence interval (CI) 2.5-788716.3, P = 0.008] and longer device dwell time [OR 1.4; 95% CI 1.1-2.4, P = 0.008].
conclusionRemoval of tine-based LPMs, typically after short- to mid-term device dwell times, was generally feasible and safe.
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