A rare case of very late dislodgement of a Medtronic SelectSecure 3830 lead occurred three years post-implantation, requiring extraction and replacement with a conventional lead.
Very late lead dislodgement can occur with lumenless leads used for left bundle branch area pacing even years after successful implantation, requiring continued vigilance.
Absolute Event Rate: 0% vs 0%
ABSTRACT We report a rare case of very late dislodgement of a Medtronic SelectSecure 3830 lumenless lead three years after successful left bundle branch area pacing. An 88‐year‐old patient with permanent atrial fibrillation and bifascicular block underwent VVIR pacemaker implantation in 2022 with excellent initial parameters (threshold 0.8 V at 0.5 ms, impedance 650 Ω) and stable follow‐up for three years. The patient presented with pre‐syncopal episodes, and device interrogation revealed capture failure with elevated threshold (2.25 V/0.4 ms) and decreased impedance. Fluoroscopic comparison confirmed macro‐dislodgement of the lead with coiling in the pacemaker pocket. The SelectSecure lead was successfully extracted and replaced with a conventional stylet‐driven lead positioned in the right ventricular mid‐septum. This case highlights that late lead dislodgement can occur with lumenless leads even years after successful implantation, emphasizing the need for continued vigilance during long‐term follow‐up of cardiac physiological pacing systems.
Kumar et al. (Wed,) reported a other. A rare case of very late dislodgement of a Medtronic SelectSecure 3830 lead occurred three years post-implantation, requiring extraction and replacement with a conventional lead.