Percutaneous transcatheter repositioning of displaced permanent pacemaker lead

New technique: repositioning of dislodged atrial pacing lead with a specially designed urological basket

The rate of dislodgement of atrial pacing leads is approximately 3%. To solve this problem, reoperation and repositioning of these leads is one of the solutions. Some operators have reported repositioning these leads with snare systems or deflectable catheters. In this communication, we present a new method using a specially designed urological basket to solve this problem.

Percutaneous transcatheter repositioning of displaced permanent pacemaker atrial lead with a simple system

A 48-year-old man who was implanted with a DDD-R pacemaker because of sick sinus syndrome eight days ago presented to our institute with a syncopal attack. Fluoroscopy showed a dislodged active fixation atrial pacemaker lead. With a snare system simply improvised from a 0.014 inch guidewire and a NIH catheter, the lead was repositioned via percutaneous transfemoral approach. The procedure was easy and completed without any complication. Follow-up controls after two weeks and three months showed stability of the lead position with normal pacing and sensing functions.