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Related Experiment Video

Updated: Jul 15, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

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Published on: February 28, 2012

First experience with a new active fixation coronary sinus lead.

H Nägele¹, M Azizi, S Hashagen

¹Medical Department, St Adolfstift, Hamburgerstr. 41, D-21465 Reinbek, Germany. naegele@uke.uni-hamburg.de

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology

|April 24, 2007

Summary

The new active fixation coronary sinus (CS) lead (4195) shows fewer dislocations and more stable thresholds than older passive fixation models. However, lead extraction can be challenging.

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Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

Published on: April 21, 2013

Area of Science:

Cardiology
Medical Devices
Implant Technology

Background:

Coronary sinus (CS) lead implantation is complex due to variable anatomy and high dislocation rates.
Conventional CS leads utilize passive fixation, leading to challenges in long-term stability.
Technological advancements have introduced active fixation leads for improved performance.

Purpose of the Study:

To evaluate the clinical performance of the novel active fixation CS lead (Attain 4195).
To compare the dislocation rates and threshold stability of the active fixation lead against conventional passive fixation models.
To assess the safety and feasibility of active fixation CS lead implantation.

Main Methods:

A prospective study involving 403 CS lead implantations in 368 patients from 1999 to 2007.
Leads were categorized into straight passive, curved passive, and active fixation groups.
Kaplan-Meier analysis and 3-month follow-up data were used to compare lead performance and stability.

Main Results:

Active fixation leads demonstrated significantly lower dislocation rates compared to straight and curved passive fixation leads (P < 0.001).
The active fixation lead (4195) maintained stable thresholds, unlike passive leads which showed significant increases after 24 hours.
Two cases reported difficulties in retracting the active fixation lead due to phrenic nerve stimulation.

Conclusions:

The active fixation CS lead (4195) offers superior dislocation resistance and threshold stability compared to conventional passive fixation leads.
While effective, the active fixation mechanism may present challenges during lead extraction.
Further investigation into extraction techniques for active fixation CS leads is warranted.