MIGRATION AND RIGHT ATRIAL PERFORATION OF AN ACCUFIX ATRIAL LEAD RETENTION WIRE FOLLOWING PARTIAL LEAD REMOVAL DURING MYOMECTOMY

A 36-year-old man with a history of hypertrophic obstructive cardiomyo pathy presented to the emergency room with ''stabbing'' chest pain. He had undergone dual-chamber pacemaker implantation in 1993 using an at rial lead (Accufix; Telectronics; Englewood, Cole) and a myomectomy in 1996 during which the distal portion of the atrial lead was removed. Digital fluoroscopy revealed that the retention wire had migrated out of the remaining atrial lead and perforated the right atrium. The rete ntion wire was successfully removed pel cutaneously. The need for comp lete removal of the retention wire in the Accufix lead at the time of open-heart surgery is emphasized.