Cross-Platform Retrieval of a Chronically Implanted Leadless Pacemaker Using a Dedicated Retrieval System

BACKGROUND: Leadless pacemakers are increasingly used in patients in whom transvenous pacing leads are undesirable. However, management at battery depletion remains challenging, particularly for chronically implanted devices. CASE SUMMARY: A 74-year-old woman with prior bioprosthetic tricuspid valve replacement, atrial fibrillation, and complete atrioventricular block underwent leadless pacemaker implantation in 2019. At follow-up, device interrogation demonstrated battery depletion. A new leadless pacemaker was implanted via right femoral venous access. The chronically implanted device, located in the mid-right ventricular septum, was subsequently retrieved using a trilobed snare system. Engagement required multiple attempts because of difficulty achieving coaxial alignment; however, after capture, the device was recaptured and removed with minimal resistance and without arrhythmia, pacing instability, or complication. CONCLUSION: This case demonstrates the feasibility of cross-platform retrieval of a chronically implanted leadless pacemaker after prolonged dwell time in selected patients.