A modified transvenous single mechanical dilatation technique to remove a chronically implanted active-fixation coronary sinus pacing lead.

We described a 77-year-old patient, previously implanted with a dual-chamber pacemaker later upgraded to a cardiac resynchronization therapy-defibrillator (CRT-D) device with an active-fixation coronary sinus pacing lead, who underwent a transvenous mechanical extraction procedure for a device-related systemic infection. All leads were removed successfully with a transvenous approach. With regard to the coronary sinus (CS) lead (Attain 4195 StarFix, Medtronic Inc., Minneapolis, MN, USA), manual traction was ineffective and extraction required long and challenging mechanical dilatation up to distal CS using either conventional sheaths or modified CS lead delivery. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.