Between July 2010 until September 2011, we implanted 4F active fixation leads (SelectSecure Model 3830, Medtronic, Minneapolis, MN, USA) in three patients with prosthetic tricuspid valve who required ventricular pacing. Active fixation leads were used in view of lead instability with conventional coronary sinus pacing leads. The lead was positioned and actively fixed at its optimal at the distal coronary sinus. The performances of the leads and its related complications were then monitored.
The leads were successfully implanted in all three patients. The peri implantation pacing parameters were within acceptable limits with pacing thresholds of 2.3, 1.2 and 0.5 V, respectively and pacing impedances of 1450, 817 and 1384 ¦¸. Follow up interrogation revealed stable pacing parameters. No immediate complications were observed.
A 4F active fixation lead placement at the distal coronary sinus to deliver left ventricular stimulation in patients with prosthetic tricuspid valve showed stable and consistent delivery of acceptable pacing performances.