Comments

• pacemaker leads are either equipped with tines (passive fixation) or with a screw (active fixation); both types of electrodes provide similar results in a long-term follow-up and the use of one or the other electrode type is mainly based on the implanter´s preference
• active fixation is accomplished by means of a screw tip, which can be visible on chest X-ray
• passive fixation leads are caught in the trabeculae lining the atrium or ventricle
• chest radiography is the preferred imaging modality to evaluate leads location, lead wire integrity and help in identifying several complications
• lead dislodgements have been classified as “macrodislodgement” versus “micro-dislodgement”, early versus late dislodgement
• macrodislodgement is radiographically evident whereas microdislodgement is not (harder to detect)
• early dislodgements occur within the first six weeks after implantation, and late dislodgements, after this period of time
• early dislodgements are much more frequent than late dislodgements and affect more frequently atrial leads