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Updated: Jun 12, 2026
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
A modified transvenous single mechanical dilatation technique to remove a chronically implanted active-fixation
Maria Grazia Bongiorni1, Andrea Di Cori, Giulio Zucchelli
1Hospital University of Pisa, Department of Cardiovascular Diseases 2, Pisa, Italy.
Pacing and Clinical Electrophysiology : PACE
|May 22, 2010
Summary
Systemic infection necessitated transvenous mechanical extraction of a cardiac resynchronization therapy-defibrillator (CRT-D) system. Extraction of the coronary sinus lead proved challenging, requiring extensive dilatation for removal.
Area of Science:
- Cardiology
- Medical Device Technology
Background:
- A 77-year-old patient presented with a systemic infection related to a previously implanted cardiac resynchronization therapy-defibrillator (CRT-D) device.
- The patient's CRT-D system included an active-fixation coronary sinus pacing lead.
Observation:
- A transvenous mechanical extraction procedure was performed to remove the infected device and leads.
- Manual traction on the coronary sinus lead was ineffective for removal.
Findings:
- Successful transvenous removal of all leads was achieved.
- Extraction of the coronary sinus lead necessitated prolonged and challenging mechanical dilatation, extending to the distal coronary sinus.
- Both conventional sheaths and modified delivery systems were employed during the challenging lead extraction.
Implications:
- This case highlights the complexities and potential difficulties associated with transvenous lead extraction, particularly for coronary sinus leads.
- Advanced mechanical dilatation techniques may be crucial for managing challenging lead extractions in patients with cardiac implantable electronic devices.
- Successful lead extraction is vital for managing device-related infections and improving patient outcomes.
