First experience in quadripolar active fixation coronary sinus lead extraction: a case report.

Area of Science:

• Cardiovascular medicine
• Medical device technology
• Electrophysiology

Background:

• The Attain Stability Quadripolar 4798 lead is a novel active fixation coronary sinus (CS) lead.
• No prior reports detail the extraction of chronically implanted 4798 leads.

Observation:

• A 52-year-old male with a history of cardiac resynchronization therapy pacemaker (CRT-P) and AV node ablation presented with a pocket infection 69 weeks post-implantation.
• Extraction of atrial and ventricular leads was straightforward.
• Coronary sinus (CS) lead extraction required significant traction due to adhesions but was successful without complications or specialized equipment.

Findings:

• This case represents the first reported extraction of a chronically implanted active fixation Attain Stability Quadripolar lead.
• Successful extraction was achieved without specialized tools, preserving the CS branch.
• Significant adhesions were observed at the active fixation site.

Implications:

• The successful extraction of this lead suggests it can be removed without specialized equipment.
• Potential difficulties due to adhesions should be considered when implanting this lead.
• This case provides valuable insights for electrophysiologists managing patients with this type of lead.