title: Evaluation and extraction of the Accufix atrial J lead.
abstract: The Accufix (Telectronics Pacing Systems, Englewood, Colo.) atrial active fixation pacemaker lead has a preformed J stiff retention wire that can fracture and erode through the atrium. We screened 85 patients with digital fluoroscopy and detected 18 (21%) lead fractures. Fourteen (16%) leads were successfully extracted by percutaneous techniques. The mean time for extraction and placement of a new atrial lead was 109 +/- 53 min, and a lead > 1 year old but not in the presence of a fracture was associated with a significantly longer extraction time. There were two extraction complications. One patient had a fever following the extraction, and one patient had a focal sensory deficit 1 week after the extraction probably caused by a paradoxical embolus. Standard percutaneous extraction tools can be used for successful and safe removal of a fractured Accufix lead.
authors.affiliation: Department of Internal Medicine, University of Michigan Hospital, Ann Arbor 48109-0022, USA.
authors.forename: E G
authors.initials: EG
authors.lastname: Daoud
authors.forename: W
authors.initials: W
authors.lastname: Kou
authors.forename: T
authors.initials: T
authors.lastname: Davidson
authors.forename: M
authors.initials: M
authors.lastname: Niebauer
authors.forename: F
authors.initials: F
authors.lastname: Bogun
authors.forename: M
authors.initials: M
authors.lastname: Castellani
authors.forename: K K
authors.initials: KK
authors.lastname: Chan
authors.forename: R
authors.initials: R
authors.lastname: Goyal
authors.forename: M
authors.initials: M
authors.lastname: Harvey
authors.forename: S A
authors.initials: SA
authors.lastname: Strickberger
authors.forename: K C
authors.initials: KC
authors.lastname: Man
authors.forename: F
authors.initials: F
authors.lastname: Morady
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy; D004567:Electrodes, Implanted; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011856:Radiographic Image Enhancement; D015642:Radiology, Interventional; D013997:Time Factors