title: Straight screw-in atrial leads "J-post shaped" in right appendage versus J-shaped systems for permanent atrial pacing: a safety comparison.
abstract: OBJECTIVE
  The reliability of active-fixation atrial leads has been compared with that of passive-fixation leads; comparisons have also been made between straight and J-shaped screw-in lead systems. However, few data are available on procedural and short-term safety. This retrospective study compared the procedural safety of non-pre-shaped screw-in leads with that of passive- and active-fixation J-shaped leads.
  
  
  METHODS
  From January 2004 to January 2010, 1,464 patients underwent new pacemaker/implantable cardioverter-defibrillator implantation. Of these, 915 (study population) received a passive- or active-fixation pre-J-shaped lead, or a straight screw-in atrial lead; the remaining 549 patients, who received only a ventricular lead, were excluded. The three study groups were: Group S-FIX (165 patients, 18%), receiving a straight screw-in atrial lead (postshaped in the right appendage); Group J-PASS (690 patients, 75.4%), receiving a passive-fixation J-shaped atrial lead; and Group J-FIX (60 patients, 6.6%), receiving an active-fixation screw-in J-shaped atrial lead. Procedural and short-term complication rates were analyzed up to 3 months postimplantation.
  
  
  RESULTS
  One complication occurred in each group (S-FIX 0.6% vs J-PASS 0.1% vs J-FIX 1.6%, P = 0.3, 0.1, and 0.4, respectively, for each comparison). The rate of atrial lead dislodgement was higher in Group J-PASS than in S-FIX but not J-FIX (Group S-FIX 0 vs Group J-PASS 16 vs Group J-FIX 1 dislodgements; P = 0.04 and 0.7, respectively).
  
  
  CONCLUSIONS
  Straight screw-in atrial leads, "J-post shaped" in the right appendage, offer better stability than passive-fixation J-shaped leads and display a similarly acceptable safety profile compared with both the J-shaped systems.
authors.affiliation: Unità Dipartimentale di Elettrofisiologia, Dipartimento di Cardiologia, Mirano (Venice), Italy. francozoppo@vodafone.it
authors.forename: Franco
authors.initials: F
authors.lastname: Zoppo
authors.forename: Francesca
authors.initials: F
authors.lastname: Zerbo
authors.forename: Glauco
authors.initials: G
authors.lastname: Brandolino
authors.forename: Enrico
authors.initials: E
authors.lastname: Bacchiega
authors.forename: Antonio
authors.initials: A
authors.lastname: Lupo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control*; D004567:Electrodes, Implanted; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010138:Pacemaker, Artificial; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors