Clinical and radiographic presentation of patients injured by j-wire fracture in certain telectronics atrial pacemaker leads: A potentially treatable cause of cardiovascular collapse

David T. Kawanishi, J. A. Brinker, C. J. Love, R. C. Reeves, A. Rozkovec, M. L. Mutter, G. Pioger, J. N. Gross, F. J. Hildner, J. Westcott, M. Davis, J. C. Petitot, N. Goldschlager, J. Fee

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Abstract

Purpose: Identify the clinical and radiographic findings in patients injured by fracture of a J-shape retention wire in some Telectronics atrial permanent pacemaker leads. Methods: All reported injury due to fracture of a J-wire in the active fixation ("Accufix," mostly model 033-801) and passive fixation (mostly model 033-854) atrial leads were tabulated along with any chest x-ray or cinefluoroscopic (CXR/FL) visualization of protrusion (Prot) of the J-wire. Results: # pts (%) # pts (%) Lead model 033-801 033-854 FATAL Tamponade/shock 5 0 Prot on CXR/FL 3 (60) - NONFATAL Tamponade 14 1 Pericard Eff 5 1 Atrial Perf 2 0 Embolized Frag 4 0 Other 1a 4b Total 26 6 Prot on CXR/FL 24 (92) 6 (100) Pericard Eff=pericardial effusion; Perf.=perforation; Frag=fragment; a=right atrium-to-aorta fistula; b=chest pain. A protrusion was seen in all injured pts. who had a CXR/FL study done. Conclusions: 1. J-wire fracture with protrusion may cause cardiovascular collapse and death; 2. The protruding fracture may be visible on CXR/FL. Clinical Implications: Injury due to a protruding J-wire fracture should be considered in patients who have these atrial pacemaker leads and who present with chest pain, pericardial effusion, tamponade, or shock.

Original languageEnglish (US)
Pages (from-to)152S
JournalChest
Volume110
Issue number4 SUPPL.
Publication statusPublished - Oct 1 1996
Externally publishedYes

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kawanishi, D. T., Brinker, J. A., Love, C. J., Reeves, R. C., Rozkovec, A., Mutter, M. L., ... Fee, J. (1996). Clinical and radiographic presentation of patients injured by j-wire fracture in certain telectronics atrial pacemaker leads: A potentially treatable cause of cardiovascular collapse. Chest, 110(4 SUPPL.), 152S.