Treatment of Patients with Prior Exit Block Using a Novel Steroid‐Eluting Active Fixation Lead

An increased interest has developed in active fixation leads for several reasons. Exit block is an uncommon complication that is seen with both active and passive fixation leads. Exit block has not been a significant problem with passive fixation steroid‐eluting leads and has been treated with these leads. A new steroid‐eluting active fixation lead was examined for its performance in patients in whom exit block had previously occurred. The lead function was evaluated prospectively in 24 patients with a history of exit block (15 ventricular and 9 atrial). The results in patients with atrial exit block are encouraging with an average chronic stimulation threshold of 0.19 msecs at 2.5 volts. Results in the ventricle are less encouraging with 3 occurrences of recurrent exit block in 15 patients; however, the remaining patients had a good mean threshold of 0.21 ±0.11 msecs at 2.5 volts. There were a remarkable number of non–lead related complications suggesting that this is a substantially different group than routine implantations.