Lessons learned from Micra leadless pacemaker retrieval: a case series.

Background: Retrieving an implanted leadless pacemaker is a challenging component of its management. However, there are no dedicated tools specifically designed for retrieving the Micra leadless pacemaker. Given the lack of commercial retrieval systems, there is an urgent need to document and validate alternative interventional strategies to manage complications associated with device malfunction or migration. Case summary: In this series, we present cases involving increased capture threshold, device embolization into the right pulmonary artery, and broken tines following Micra implantation. We successfully completed four retrieval procedures using a coordinated approach with existing devices, including the Micra transcatheter pacing system, coronary angiography catheter, and endovascular snare system. Discussion: Notably, these cases exhibited different characteristics during the retrieval of the Micra leadless pacemaker, which may assist colleagues in dealing with such scenarios. Our experience demonstrates that a strategy combining the Micra delivery catheter with an endovascular snare system, without the need for a steerable sheath, was sufficient and effective for successful Micra retrieval.