This report provides a practical technique for repositioning a dislodged lumenless pacing lead using a homemade snare, avoiding the need for complete lead extraction and reimplantation.
May offer bailout for dislodged 3830 leads without extraction; leaves open reproducibility and safety in larger series.
The SelectSecure catheter delivery system and active fixation 4.1 French diameter Model 3830 pacing lead (Medtronic, Inc, Minneapolis, MN, USA) has the advantage of permitting precise implant at nearly any desired location due to catheter maneuverability. However, as the lead lacks an internal stylet lumen, it is intrinsically floppy and any repositioning after the delivery catheter is removed is nearly impossible, necessitating lead extraction and a repeat of the implant process. At present, there are no commercially available tools to precisely reposition this lead. This report presents a simplified approach to reimplant a dislodged Model 3830 lead using currently available materials to create an effective maneuverable and removable encircling snare.
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Karpawich et al. (2008) studied this question.
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