What is a potential risk of passive lead fixation?

• A. Leads could pop out
• B. Leads always secure
• C. Causes immediate heart attack
• D. Leads become inert

Answer: (A)

Passive fixation relies on tines that grab onto heart trabeculae rather than screwing into the muscle. Because the lead is not firmly threaded into the myocardium, it can become dislodged or migrate with body movement, growth, or changes in surrounding tissue. That makes lead dislodgement a genuine potential risk with passive fixation, leading to loss of pacing or sensing and often requiring repositioning or re-implantation.

The other statements don’t fit because a lead fixed passively is not guaranteed to stay put, so “always secure” isn’t accurate. Immediate heart attack isn’t a typical direct consequence of a dislodged passive lead, and leads don’t become “inert” simply from this fixation method—they can fail electrically or metabolically, but not as a direct outcome of passive fixation itself.