Modification of lumenless leads
The lack of a central lumen in the 3830 pacing lead changes the available techniques for modifying a pacing system. In a standard Bisping (extendable-retractable) active-fixation lead, if the lead were to dislodge or develop a high threshold, it could simply be unscrewed and then affixed to a new location. This is not the case with these lumenless leads. The lead must be replaced. In addition, chronic model 3830 leads should not be re-used. This lead has steroid that is externally applied to the electrode. The product manual specifies that there is a target amount of 17.2 mcg of beclomethasone dipropionate [10], which elutes over a period of time. After several weeks, one would expect there to be much less steroid on the lead. Therefore, while acute repositioning is certainly possible, chronic repositioning, is not recommended because the benefits of a steroid-eluting lead may not be present. In contrast, the investigational Next Generation Defibrillator Lead utilizes a standard collar that allows steroid elution over a longer period of time.