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

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.

Challenging lead extraction with quadripolar active fixation of coronary sinus with severe adhesion

“… 4 Among the small number of reports of Attain Stability lead extraction, the longest lead implantation period was 63 months. 5 , 6 , 7 , 8 , 9 , 10 In that report, the bipolar lead was easily and safely removed by simple traction using a standard stylet without using an additional tool. 10 We are aware of only 1 previous report of ASQ lead extraction.…”

“… 5 , 6 , 7 , 8 , 9 , 10 In that report, the bipolar lead was easily and safely removed by simple traction using a standard stylet without using an additional tool. 10 We are aware of only 1 previous report of ASQ lead extraction. 11 In the report, the period from implantation was 16 months and the ASQ lead could be extracted with simple manual traction, although severe adhesion was observed at the helix site.…”