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Coronary sinus lead fragmentation 2 years after implantation with a retained guidewire

Herbert Nägele1, Sandra Hashagen, Mehmet Ergin

  • 1St. Adolfstift, Medical Clinic, Reinbek, Germany. naegele@uke.uni-hamburg.de

Pacing and Clinical Electrophysiology : PACE
|March 21, 2007
PubMed

Insights

Cardiac Resynchronization Therapy (CRT) using coronary sinus leads can be complicated by dislocations. A retained guidewire technique was used, but lead and guidewire fracture occurred two years post-implantation.

Area of Science:

  • Cardiology
  • Medical Devices
  • Implant Technology

Background:

  • Cardiac Resynchronization Therapy (CRT) is vital for treating congestive heart failure (CHF) in patients with conduction delays.
  • Coronary sinus (CS) lead implantation for CRT is challenging, with a 10% rate of dislocations.
  • The retained guidewire technique aims to stabilize CS leads during implantation, especially after dislocations.

Observation:

  • This case report details a rare complication following CS lead implantation.
  • The patient received a CS lead utilizing the retained guidewire technique for stabilization.
  • The complication occurred two years after the initial implantation procedure.

Findings:

  • The study reports a fracture of both the coronary sinus (CS) lead and the retained guidewire.
  • This fracture occurred two years after the implantation procedure.
  • This highlights a potential long-term complication associated with the retained guidewire technique.

Implications:

  • The findings suggest potential long-term risks associated with the retained guidewire technique for CS lead implantation.
  • Further investigation is needed to understand the mechanisms of lead and guidewire fracture in this context.
  • This may inform future strategies for improving the durability and safety of CRT lead implantation procedures.

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