EXTRACTION OF THE TELECTRONICS-ACCUFIX-330-801 ATRIAL LEAD - THE MAYO-CLINIC EXPERIENCE

Objective: To document a cumulative experience with removal of the Tel ectronics 330-801 Accufix atrial lead after it was withdrawn from the market. Design: We reviewed our results with 96 attempted lead extract ion procedures through Dec. 1, 1995. Material and Methods: All patient s underwent preoperative assessment, including fluoroscopic screening of the lead. Patients had blood typing and screening done before the e xtraction procedure, and extractions were performed with cardiac surgi cal intervention available. Pacing dependence was assessed to determin e the need for temporary pacing. Results: The mean patient age was 65. 7 +/- 1.6 years, and the mean duration of lead implantation was 31.0 /- 1.4 months. Of the 96 lead extractions attempted, 94 were successfu l. Of the 96 cases, the retention wires were normal in 29, fractured w ithout protrusion in 34, and fractured with protrusion in 33. Fifty-th ree leads were removed with use of simple traction only, and seven lea ds were removed by using a locking stylet and telescoping sheaths. The Cook workstation was used in the removal of 32 leads through the femo ral vein; in 1 of these 32 patients, the retention wire was removed be fore lead extraction. The retention wire was removed but the lead was left intact in one patient. One lead was removed during an operative m aze procedure. Associated complications were minimal. Conclusion: Alth ough lead extraction is a potentially fatal procedure, the Telectronic s 330-801 Accufix atrial lead can be extracted safely with minimal mor bidity when performed by experienced personnel.