The leads of cardiac conduction devices can be secured in the heart by passive or active fixation. Passively fixed leads have tines, fins, helices, or conical structures at their tip that lodge in the cardiac trabeculae to maintain lead stability. Actively fixed leads (shown above) have a corkscrew helix at their tips that screws into the myocardium to maintain stability in wide range of intracardiac locations.
After about a month or so, scar tissue will stabilize the leads regardless of the mechanism of initial fixation.
Refernces
Aguilera AL, Volokhina YV, Fisher KL. Radiography of cardiac conduction devices: a comprehensive review. Radiographics. 2011 Oct;31(6):1669-82.
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