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When Stability Fails: Rare Very Late Dislodgement of 3830 Lead
Dilip Kumar1, Niladri Ghosh1, Ashesh Halder1
1Manipal Hospital EM Bypass Kolkata Kolkata India.
Clinical Case Reports
|February 2, 2026
Summary
Late dislodgement of a Medtronic SelectSecure lumenless lead occurred three years after successful left bundle branch area pacing. This rare event in pacemaker patients underscores the need for ongoing monitoring of cardiac pacing systems.
Area of Science:
- Cardiology
- Medical Device Technology
Background:
- Left bundle branch area pacing (LBBAP) is an advanced technique for physiological pacing.
- Lumenless leads offer specific advantages but may have unique complications.
- Very late lead dislodgement is an uncommon but significant complication.
Purpose of the Study:
- To report a rare case of very late dislodgement of a lumenless pacing lead.
- To highlight potential long-term risks associated with specific lead designs.
- To emphasize the importance of continued surveillance in cardiac pacing.
Main Methods:
- Case report of an 88-year-old patient with permanent atrial fibrillation and bifascicular block.
- Successful implantation of a Medtronic SelectSecure 3830 lumenless lead for VVIR pacing.
- Follow-up over three years, followed by investigation of pre-syncopal episodes and device malfunction.
Main Results:
- The patient experienced pre-syncopal episodes three years post-implantation.
- Device interrogation revealed capture failure, elevated pacing threshold, and decreased impedance.
- Fluoroscopy confirmed macro-dislodgement of the lumenless lead, which had coiled in the pacemaker pocket.
Conclusions:
- Late lead dislodgement can occur with lumenless leads years after initial successful implantation.
- This case necessitates continued vigilance during long-term follow-up of patients with cardiac physiological pacing systems.
- Successful lead extraction and replacement with a conventional lead were performed.
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