Lumen-Based En Bloc Extraction of a Bound Lead Pair Using a Rotational Mechanical Sheath

Atrial lead failure in a dual-chamber system may necessitate ventricular-only pacing, such as Ventricle-paced, Ventricle-sensed, Inhibited (VVI) mode, thereby eliminating atrioventricular (AV) synchrony and exacerbating symptoms, particularly in patients with heart failure. When a chronic lead becomes non-functional, management may require lead abandonment or extraction with system revision 1. A major risk factor for extraction complications is lead-to-lead binding 2, which manifests as unit motion where inseparable leads move in tandem and create a recurrent point of resistance despite standard techniques.