Leadless Pacemaker

[Hannigan5]

Hi everyone!

I am 38 and currently on a waiting list for a leadless pacemaker and I just wanted to see if there is anyone on here who has had one and how they are getting on with it Also just wondered about how things were at the procedure. I have done a bit of research online and watched some bits on youtube about the procedure but its always nice to speak to others that have gone through the same thing. Thanks!

[Friendliarthur]

From Australia

Hi,

I’m not a medico but I made enquiries before receiving my PPM with leads. I chose not to have leadless.

Most PPM descriptions say that batteries last for up to 15 years. As well, leadless models that fail are abandoned and stay within the ventricle. So after 45 years you’d possibly have 3 abandoned units in your right ventricle???

It may be that this can’t happen ….. common practice might be to replace the first failed one with a leaded model after the first leadless is abandoned when battery is worn out. But also bear in mind that leadless models are relatively new technology..

Of course if you have medical advice contra to what I have written, please take it, not mine. But since you are a young person with hopefully many lots of 15 year periods ahead, it might be worth checking out this info if it is something you haven’t yet considered.

All the best.

[Lezzers in reply to Friendliarthur]

Hi friendlyaustralia

Could I ask where you got the information that leadless pacemakers are left in situ, I'd really like to follow that up. I know that redundant leads are left in situ but leaving a redundant device is a new one on me. Though I do believe that because the battery life is so good it's assumed you'll only ever need one in your lifetime but of course these heart devices on rare occasions do fail.

Thanks

[Ennasti in reply to Lezzers]

I did a quick google and it seems that leaving the old device where it is does indeed happen - have a look here: medtronic.com/au-en/patient...

This site states:

What happens when the Micra battery runs low?

Micra is designed to provide options when a new device is needed. It may be turned off and a new Micra or a traditional system may be implanted. The Micra also offers a retrieval feature to enable retrieval, when possible. Your doctor will determine what is best for you

[Lezzers in reply to Ennasti]

Yes, I've just done a quick research too & found the same info. It can be removed but apparently there's room in the ventricle for more than one device! That's really interesting as it's never been mentioned in any of the support groups that I belong to. I did also read the device failure is less common with leadless pacemakers, less than 2% which is reassuring.

my.clevelandclinic.org/heal...

[Friendliarthur in reply to Lezzers]

Hi

Here’s info from Cleveland Clinic USA.

It says failed ones remain but they MAY be removed.

I’d be interested to know how. Open heart surgery??????

my.clevelandclinic.org/heal...

[Friendliarthur in reply to Lezzers]

Hi again.

Here is an excerpt from a 2023 study of leadless PPMs

“Effectively, the LPPM can either be extracted or abandoned before implanting a new device. In older devices, encapsulation may be an issue and abandonment could be a reasonable strategy. Unsuccessful retrieval is caused by complete encapsulation of the device, but the degree of Micra encapsulation is unpredictable. In the event of retrieval failure, the LPPM can be abandoned and a new system should be implanted at a different location in the RV, which is the recommended strategy from the manufacturer to reduce the risk of complications. However, abandonment may not be an appealing option, particularly in younger patients who can be expected to need several pacemaker replacements in their lifetime. There is no definitive answer as to how many devices can be implanted and abandoned before this becomes problematic or whether there are long-term risks of an abandoned LPPM. Surgical removal of the LPPM is an option when absolutely indicated and when percutaneous retrieval is not possible.”