LAUSR

Multiple MTPS may affect the proper functioning of the remote monitor. Introduction The Micra Transcatheter Pacing System (MTPS, Medtronic, Minneapolis, MN) is a novel expanding technology with some potential advantages over traditional transvenous pacing systems, especially in regard to leadand pocketrelated complications. Accumulating scientific evidence supports the safety and effectiveness of MTPS technology. A relevant open question is end-of-life (EOL) management of the MTPS. To date, given the absence of a specific extraction tool and the procedural risks of approaching a fully encapsulated device, the current opinion and recommendation of the manufacturer is to abandon and turn off the old device and implant a new one. However, there is very little data to support the feasibility and safety of multiple Micra implantation in humans. The management of a unique, challenging case of an achondroplastic dwarf is described, previously implanted with an MTPS that prematurely reached EOL, owing to progressive threshold elevation and 100% right ventricular (RV) pacing.