Coronary Sinus Lead Removal: A Comparison between Active and Passive Fixation Leads
Simon Pecha1, Charles Kennergren2, Yalin Yildirim1
1Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
Plos One
|April 28, 2016
Summary
Removing active fixation coronary sinus (CS) leads, specifically the StarFix model, proved more challenging than passive fixation leads. Our study found a higher failure rate for active fixation CS lead removal.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Coronary sinus (CS) lead implantation can be challenging due to anatomical variations and dislodgement risks.
- Recent advancements have focused on evolving CS lead fixation methods.
Purpose of the Study:
- To compare the procedural success and variables of removing active versus passive fixation coronary sinus leads.
Main Methods:
- A retrospective analysis of 22 CS lead removal procedures (6 active, 16 passive) between 2009 and 2014.
- Procedures utilized simple traction or locking devices, with or without laser extraction sheaths.
- Data collected included procedural variables and success rates.
Main Results:
- Active fixation leads (Medtronic Attain StarFix) had a 50% removal success rate compared to 100% for passive fixation leads (p=0.013).
- Active fixation leads were removed after a shorter mean implantation time (9.9 months) than passive leads (48.7 months) (p=0.012).
- Infection was the indication for removal in all cases, with no 30-day complications or deaths.
Conclusions:
- The removal of Medtronic Attain StarFix active fixation CS leads demonstrated a higher procedural failure rate compared to passive fixation leads.
- These findings suggest potential challenges associated with active fixation lead retrieval.
