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.