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.