title: The novel active fixation coronary sinus lead: efficacy and safety of transvenous extraction procedure.
abstract: OBJECTIVE
  Benefits of cardiac resynchronization therapy (CRT) are well known for heart failure; however, some patients might experience complications related to the coronary sinus (CS) lead (high pacing threshold, phrenic nerve stimulation, and dislodgment) with unfavourable impact on quality of life, costs, and management. Lead stability is one of the most common unmet needs for CRT procedures.
  
  
  RESULTS
  Recently, new model Medtronic 20066 Attain Stability(®) (Maastricht, The Netherlands) active fixation LV lead has been released, to overcome this issue. The lead has a small side helix of 0.20 mm (0.008 in.) that allows for secure placement of the lead within the vein at the desired location. We report our first experience with the extraction of this novel active fixation left ventricular lead.
  
  
  CONCLUSIONS
  In our case, to our knowledge the first reported in humans, the extraction of this new model of active fixation lead was proved to be a safe and effective procedure at 8 months after implantation. Indeed, under angiographic and fluoroscopic check, there was no documented dissection or damage to the CS during and after removal of the lead. The rotation manoeuvre was effective when combined with moderate traction of the lead itself.
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bontempi
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy vassanella@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Vassanelli
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Najat
authors.initials: N
authors.lastname: Ashofair
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Inama
authors.affiliation: Medtronic Italia, Milano, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Mariggiò
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Manuel
authors.initials: M
authors.lastname: Cerini
authors.affiliation: Chair and Unit of Cardiology, University of Brescia, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D058406:Cardiac Resynchronization Therapy; D058409:Cardiac Resynchronization Therapy Devices; D017023:Coronary Angiography; D054326:Coronary Sinus / Q000000981:diagnostic imaging; D020878:Device Removal / Q000379:methods*; D004867:Equipment Design; D004868:Equipment Failure; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000150:complications; D008297:Male; D010690:Phlebography; D016896:Treatment Outcome
keywords: Cardiac resynchronization therapy; Coronary sinus lead; Left ventricular active fixation lead; Transvenous lead extraction