Figure 3.
3(A) Technical representation and legend of a stylet-driven
lead.
3(B) Steps to prepare the helix for LBBAP: After exposition of
the screw, pre-tensioning of the inner coil is provided by clockwise
rotations (CWR) of the stylet insertion tool. The torque on the inner
coil is later maintained by plugging the stylet insertion tool onto the
first silicon sealing of the electrode.
3(C) Manual counter-clockwise rotations (CCWR) of the outer
lead body without appropriate fixation of the connector pin.
Illustration of the paradoxical effect of further helix extension or
inner coil over-tensioning (with eventual rupture of the rotating
mechanism).
3(D) With adequate fixation of the connector pin, CCW torque
applied to the outer lead body is progressively transmitted to the screw
and allows for lead removal.