REMOVAL OF THE PROTRUDING RETENTION WIRE VIA A FEMORAL APPROACH WHILELEAVING THE ACTIVE-FIXATION ATRIAL J-LEAD IN-SITU - A TECHNIQUE FOR THE MANAGEMENT OF CLASS-III ATRIAL J-LEADS

The Telectronics Accufix Atrial ''J'' pacing lead poses a mechanical r isk to patients of retention wire fracture and protrusion. Standard le ad extraction techniques include percutaneous approaches, which are as sociated with significantly risk of morbidity and mortality, and open procedures, which necessitate thoracotomy. In nine patients referred w ith Class III retention wire fractures, attempts were made to snare th e protruding retention wire from a femoral approach using snare device s and bioptomes, In six cases, the retention wire was successfully rem oved, leaving the lead body in place. In four patients with lead funct ion that was able to be evaluated, the atrial lend remained functional after the procedure. There were no complications. Snare removal of th e protruding retention wire via a femoral approach should be considere d as an option in the management of patients with Class III Accufix le ads.