Protrusion without fracture of the Accufix atrial "J" lead retention wire

The Telectronics Accufix atrial "J" lead has been associated with injury and death. These complications have occurred as the result of retention wire fracture, extrusion, and perforation of cardiac or vascular structures. This report describes a patient who was found to have protrusion of the proximal end of a nonfractured retention wire during fluoroscopic surveillance. The wire extrusion appeared to result from angulation of the lead. The lead was extracted and replaced without adverse consequences. Further prospective analysis will be needed to determine the clinical implications and approach to this complication.