Fracture and Perforation of Coronary Sinus Lead due to Retained Guide Wire During Index Cardiac Resynchronization Therapy Implantation

Our case reinforces that the retained guidewire technique should be abandoned for coronary sinus lead stabilization during cardiac resynchronization therapy. Although rarely encountered today, patients previously implanted using historical methods may present with severe mechanical complications and high-risk extraction profiles. Early recognition and referral to experienced lead extraction centers is essential.