Figure Legends
Figure 1. Fluoroscopic images of the Aveir leadless pacemaker (LP) implantation and post-implantation findings.
A-B: Right anterior oblique (RAO) and left anterior oblique (LAO) contrast images taken just before the fixation of the Aveir LP. C: Chest x-ray immediately after the implantation showing no abnormalities in the position of the Aveir LP. D-E: Chest x-ray showing that the docking button side of the Aveir LP had gradually descended. F: Cardiac CT scan showing that the helix of the Aveir LP was attached to the trabeculation within the right ventricle (RV). G-H: The 3D CT images showing that the docking button of the Aveir LP was fixed to the inferior wall of the RV.
Figure 2. Fluoroscopic images during the Aveir leadless pacemaker (LP) docking button release procedure.
A-B: Right ventricular (RV) angiography in the right anterior oblique (RAO) and left anterior oblique (LAO) views showing that the docking button side of the Aveir LP had dropped onto the inferior wall of the RV. C: The tri-loop snare was placed around the docking button of the Aveir LP, but it was difficult to grasp the docking button. D-E: An attempt was made to release the wedged docking button with an electrode catheter, but the position of the Aveir LP body could not be adjusted. F: The pigtail catheter and RadifocusTM guidewire were advanced to the caudal side of the Aveir LP body. G-H: The RadifocusTM guidewire was captured by a single-loop snare. I: The pigtail catheter was pulled from the cranial side (white arrow) and the single-loop snare from the caudal side (black arrow). J: The Aveir LP docking button was released from the inferior wall of the RV.
Figure 3. Fluoroscopic images during the Aveir leadless pacemaker (LP) retrieval and Micra LP implantation.
A-C: The tri-loop snare of the retrieval catheter successfully grasped the docking button and was docked to the Aveir LP. D: No entanglement between the Aveir LP and right ventricular (RV) structures was observed using a protective sheath. E: The Aveir LP was released from its fixation to the RV and the retrieval catheter was removed from the Aveir LP introducer. F-G: Right anterior oblique (RAO) and left anterior oblique (LAO) views of the RV angiography showing no contrast retained in the pericardial sac. H-I: The Micra LP was implanted on the inferior septum of the RV. J: The Aveir LP body and retrieval catheter had no myocardial tissue or fibrosis adhering to it.