Removal of an active fixation coronary sinus pacing lead 5 years postimplant: A case report

J Cardiovasc Electrophysiol. 2022 Nov;33(11):2411-2414. doi: 10.1111/jce.15685. Epub 2022 Oct 2.

Abstract

Active fixation for a lead in the coronary sinus may be essential to select the optimal left ventricular pacing site, maximize the effectiveness of cardiac resynchronization therapy (CRT) and avoid dislodgement. The Medtronic Attain Stability lead allows fixation through a side helix concentric with the lead body. Although electrical performance of such a lead is well known, evidence of extractability remains poor especially in the long term. We describe the removal of an Attain Stability lead 63 months after implantation which, to the best of our knowledge, is the longest implant duration that has ever been reported, in an 81-year-old male patient. It was successfully achieved using simple traction and rotation maneuvers, demonstrating the long-term removal feasibility of such device.

Keywords: cardiac resynchronization therapy; coronary sinus pacing leads; lead extraction; leadless pacing; pacemaker-bradyarrhythmias.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Cardiac Resynchronization Therapy Devices
  • Cardiac Resynchronization Therapy*
  • Coronary Sinus* / diagnostic imaging
  • Coronary Sinus* / surgery
  • Device Removal
  • Heart Failure* / therapy
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Treatment Outcome