Fracture and Lung Penetration of a Left Ventricular Lead Stabilized by Retained Stylet

During cardiac resynchronization therapy (CRT) pacemaker implantation in a 54-year-old female patient, removing the stylet resulted in repeated left ventricular (LV) lead dislodgment. Lead stability was achieved by retaining the stylet within the lead lumen. Two years after cardiac resynchronization therapy, a LV lead fracture near the connector pin occurred. The proximal lead segment was removed, and a new connector pin was attached. Two years after that, the same lead fractured in the right atrium with the stylet penetrating the lung. The LV lead and retained stylet were successfully extracted. LV lead dislodgment is a limitation of CRT, but using the retained stylet technique to achieve lead stability is potentially dangerous and is not recommended.