Spanish Pacemaker Registry. Seventh Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2009)

Failure of the Active‐Fixation Mechanism during Removal of Active‐Fixation Pacing Leads

“…The use of active‐fixation pacing leads is currently widespread and has experienced a significant increase during the last decade. According to the 2010 Spanish pacemaker registry, up to 51.5% of leads implanted during 2009 had an active‐fixation mechanism (65% of atrial leads and 45% of ventricular leads) 1 . This trend toward a predominant use of active‐fixation leads is based on the potential advantages of these electrodes: easier and rapid implantation, easier extraction, lower rates of lead dislodgement, and the possibility of pacing alternative sites different from the traditional right atrial appendage and the right ventricular apex 2–6 .…”

“…According to the 2010 Spanish pacemaker registry, up to 51.5% of leads implanted during 2009 had an active-fixation mechanism (65% of atrial leads and 45% of ventricular leads). 1 This trend toward a predominant use of active-fixation leads is based on the potential advantages of these electrodes: easier and rapid implantation, easier extraction, lower rates of lead dislodgement, and the possibility of pacing alternative sites different from the traditional right atrial appendage and the right ventricular apex. [2][3][4][5][6] Initial reluctance to their systematic use, especially in the ventricle, due to higher pacing thresholds has been overcome as different studies have demonstrated stable longterm pacing parameters.…”

“…Active‐fixation pacing leads are being widely employed due to their theoretical advantages when compared with traditional passive‐fixation leads: easy fixation and reposition, possible deployment in alternative pacing sites, lower rates of dislodgment, and chronic removability 1–8 . In general, active‐fixation leads are considered easier to extract than passive‐fixation leads 9–10 .…”

“…Active-fixation pacing leads are being widely employed due to their theoretical advantages when compared with traditional passive-fixation leads: easy fixation and reposition, possible deployment in alternative pacing sites, lower rates of dislodgment, and chronic removability. [1][2][3][4][5][6][7][8] In general, active-fixation leads are considered easier to extract than passive-fixation leads. [9][10] However, the behavior of the active-fixation mechanism during lead removal has not been yet systematically studied, and only a limited number of case reports have described occasional malfunction of the active-fixation mechanism in this setting.…”