Pacing and Sensing Interference by Air Bubble Surrounding the Non-Extended Helix of Intact Active Fixation Lead

The Lead Structure Does Not Always Work as Designed

“…The development of active lead fixation with the use of a deployed helix has dramatically lowered the incidence of lead dislodgment. 7 Although equivalent to passive fixation in long-term stability, active-fixation leads allow more choice in implant site selection and may be more amenable to lead extraction as Oginosawa et al 8 In this issue of the Journal and others have reported. 9 A lead structure with the combination of active fixation and steroid-elution is now available for worldwide use.…”

“…As performed by Oginosawa et al, 8 we also usually map the endocardium to identify the best site for pacing, with the tip of electrode remained retracted, by checking the pacing threshold, sensing amplitude and lead impedance. If the condition of the lead tip was difficult, as they encountered, the lead is suspected to have some problems, and should be replaced with a new one.…”