What would folks do?

1. Nothing, continnue to monitor
2. Abandon leads and reimplant TV DC-PPM
3. Extract leads and reimplant TV DC-PPM
4. Something else?

I'll post what we decided to do and our rationale.

This is magnified cine at left clavicle:

Curious as to how folks would approach this lead management issue.

80+ y/o, CHB, CABG, TAVR, PAF, DC-PPM with 6 year old BSci Ingevity RA/RV, EF 50%, no CHF. Bipolar imp >3000 in both leads, now unipolar pace/sense, noise with isometrics, no R waves at 30 bpm This is CXR.

Success and minimization of complications with multiple leads including dwell times of 18 years and SVC coil enhanced by femoral snaring IMO. I have seen "two-for" snaring with Cook NES but never a "three-fer" where snared Fidelis lead is providing countertraction on LV lead!

1st BSky #EPEEPS post.
Thanksgiving Lead Extraction Post
70+ year old with recurrent MRSA bacteremia, CRT-D from 2019, abandoned Fidelis lead from 2006. RA lead vegetation on RA lead. Transferred from outside hospital. Successful extraction with all leads removed. Great work by super fellow G. Peigh