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"identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2565 "Ancho" => 1333 "Tamanyo" => 305889 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cardiovascular magnetic resonance images at presentation and four months later. MDE: myocardial delayed enhancement; SSFP: steady-state free precession; STIR: short tau inversion-recovery.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cátia Costa, António M. Ferreira, Pedro Morais Sarmento, Nuno Cardim, Hugo Marques" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Cátia" "apellidos" => "Costa" ] 1 => array:2 [ "nombre" => "António M." 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Initial enthusiasm for this method of avoiding lead dislodgement was soon replaced by concerns about safety in the event of need for extraction.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The StarFix is a 5F unipolar lead, with a distal active fixation mechanism consisting of deployable lobes that expand to 24F. Deployment is achieved by advancing the outer tubing of the lead. Pulling the lead and advancing the tubing achieves acute repositioning. This mechanism for retraction of the lobes cannot be used in chronically implanted leads due not only to fibrosis involving the lobes but also to the low tension applied on them by the lead being completely inserted in the outer tubing. In our experience we have successfully extracted two of these leads (due to system infection), both implanted for more than 24 months. Extraction was performed in both cases by retracting the fixation lobes. This was achieved by progressively cutting the outer tubing and pressuring the lead with a stylet. After complete retraction of the lobes the lead was pulled out by smooth traction using a lead locking device (LLD<span class="elsevierStyleSup">®</span>, Spectranetics) (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1–4</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-10-12" "fechaAceptado" => "2015-12-20" "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 600 "Ancho" => 1376 "Tamanyo" => 122035 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A-C) Cutting the outer tubing and pressuring the lead with a stylet.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 496 "Ancho" => 1493 "Tamanyo" => 74374 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopic imaging: (A) complete triple-site cardiac resynchronization therapy defibrillator system; (B) active fixation coronary sinus lead, after extraction of both right ventricular leads; (C) initial retraction of the active fixation lead lobes.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 500 "Ancho" => 1505 "Tamanyo" => 71062 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopic imaging: (A and B) sequential retraction of the active fixation lead lobes; (C) complete retraction of the lobes and pulling of the lead into the right atrium.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 489 "Ancho" => 700 "Tamanyo" => 70187 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Active fixation coronary sinus lead after extraction.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003500000009/v2_201704020055/S2174204916301362/v2_201704020055/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000009/v2_201704020055/S2174204916301362/v2_201704020055/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301362?idApp=UINPBA00004E" ]
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