Reimplantation in Absence of Infection

The typical indication to reimplantation in absence of infection is PM/defibrillator lead malfunction. Other possible causes are reimplantation after extraction due to a superior vena cava (SVC) syndrome or need for new lead implantation in case of venous occlusion. 

In case of malfunctioning leads, we follow one of two different strategies we can abandon the nonfunctioning lead, or we can remove the old lead 

Fig 9 3 Left anterior oblique projection showing posterolateral branch of the coronary sinus vein right anterior oblique projection demonstrates stenosis at the entry b), precluding advancement of the left ventricular lead c) 

Fig 9 4 Left a and right (b)anterior oblique projections showing stenosis of the posterolateral branch of the coronary sinus vein 

Fig 9 5 Coronary sinus venography showing stenosis at the middle part of the main vessel (left anterior oblique in precluding left ventricular (LV) lead advancement. Angioplasty balloon inflation (b). Over-the-wire implantation of the LV lead in a lateral branch of the coronary sinus (c) 

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