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.