[Late failure of left ventricular leads stabilized using the retained guidewire technique in patients undergoing cardiac resynchronization therapy].
The retained guidewire technique has been proposed as an alternative method for stabilizing the left ventricular lead in patients who experience repetitive intraoperative dislocation. This article concerns three patients, out of a total of 185 (1.6%) undergoing cardiac resynchronization therapy, who had to be treated using the retained guidewire technique because of demonstrable recurrent lead dislocation. Electrode parameters were all within normal limits. Although lead dislocation could not be demonstrated macroscopically, sensing and pacing parameters were found to have changed 6 months to 1 year after implantation, with a marked elevation in impedance. Laboratory analysis showed deformation and fracture of the coil electrodes as well as deterioration of the insulation coating. In conclusion, our experience shows that the retained guidewire technique should not be used because delayed electrode damage can occur.
Arbelo
Elena
E
Servicio de Cardiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. elenaarbelo@secardiologia.es
García-Quintana
Antonio
A
Caballero
Eduardo
E
Delgado
Antonio
A
Amador
Celestina
C
Suárez de Lezo
Javier
J
Díaz-Escofet
Marta
M
Medina
Alfonso
A
D000368:Aged; D002309:Cardiology / Q000379:methods; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013997:Time Factors