Name the Device • Xray of the Week
Routine CXR for cough demonstrates metallic device. Name the cardiac implant.
Fig. 1 Device is within the myocardium of the right ventricle and is an implanted cardiac pacemaker.
Fig. 2 A different patient with 2 cardiac devices. Device A is within the myocardium of the right ventricle and is an implanted pacemaker. Device B is within the chest wall and is an implanted cardiac loop recorder.
Fig 3. The Micra intracardiac pacemaker.
Fig 4. Video showing the technique for implantation of the leadless cardiac pacemaker.
The Micra™ transcatheter pacing system (TPS) is the world’s smallest pacemaker, (1) delivered percutaneously via a minimally invasive approach, directly into the right ventricle and does not require the use of leads. It has a 99% implant success rate (2,3) and 63% fewer major complications than traditional pacemakers. (3) The Micra Pacing Capsule is 93% smaller than conventional pacemakers (4) and has an estimated average 12-year battery longevity.(2,5) The device is MRI safe up to 3 Tesla. (2).
1. Nippoldt D, Whiting J. Micra Transcatheter Pacing System: Device Volume Characterization Comparison. November 2014. Medtronic Data on File.
2. Reynolds DW, Duray GZ, Omar R, et al. A Leadless Intracardiac Transcatheter Pacing System. N Engl J Med. Published online November 9, 2015.
3. El-Chami M, et al. Leadless Pacemaker Implant in Patients with Pre-Existing Infections: Results from the Micra Post-Approval Registry. Presented at HRS May 2018. Boston, MA
4. Williams E, Whiting J. Micra Transcatheter Pacing System Size Comparison, November 2014, Medtronic Data on File.
5. Duray GZ. Ritter P, el-Chami M, et al. Long-term performance of a transcatheter pacing system: 12-Month results from the Micra Transcatheter Pacing Study. Heart Rhythm. Published online February 10, 2017.
6. Medtronic Micra Implant Manual, April, 2015
7. Eggen M, Grubac V, Bonner M. Design and Evaluation of a Novel Fixation Mechanism for a Transcatheter Pacemaker. IEEE Trans Biomed Eng. September 2015;62(9):2316-2323.
8. Eggen, M. FlexFix Tine Design. April 2015. Medtronic Data on File.
9. Bonner M, et al. Pacing Clin Electrophysiol. 2015;38:1248-1259.
10. Medtronic Micra Transcatheter Pacing System Website
Bicuspid Aortic Valve and Aortic Stenosis
Implanted Cardiac Loop Recorder
Cardiac Tamponade Following Coronary Artery Rotational Atherectomy
Papillary Fibroelastoma of Aortic Valve
Kevin M. Rice, MD is the president of Global Radiology CME
Dr. Rice serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is a radiologist with Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015, Dr. Rice and Natalie Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field.
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