Curved stylet retraction

The floppy-tip technique may be used for achieving unusual atrial lead placement with a shaight active fixation lead. This is particularly useful for placement along the right lateral atrial wall. With the curved stylet retracted 1 to 2 in., the lead tip assumes a more lateral position. By simply advancing the lead to a point of contact, the fixation mechanism can be activated and threshold measurements carried out. 

Fig. 1.27 A steer able stylet (Locator , St Jude), operated with one hand, for positioning an active fixation lead in the heart. The stylet can be used to continually and temporarily alter the curvature of the distal part of the lead without the necessity to remove or replace the stylet. Above The lead pin is attached to the guiding stylet by a setscrew attached to the bulbous clamp of the stylet handle. For a straight stylet, the arrow indicates the position of the slide next to this clamp. Below Moving the shde along the handle away from the lead gradually curves the stylet and hence the lead. The amount of movement each way determines the curvature of lead. Turning the whole handle also turns the distal curved lead within the heart. The clamp can be released from the handle and rotating the detached clamp turns the lead pin, which extends or retracts the serew mechanism. (Permission for use St Jude.)...

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