Helpful Hints

ZY Series Permanent Pacing Leads

Premature Helix Exposure
The helix (screw) of the ZY lead moves very easily and may occasionally advance prematurely. A variety of reasons cause this:

• Movement during sterilization or shipping can sometimes cause the helix to partially extend while still in the package.
• When introducing a ZY lead, handling can expose the helix.
• Turning the lead counterclockwise and using a non-screwdriver stylet can also contribute to exposing the helix.

To avoid premature helix exposure, the following suggestions may prove helpful:

DURING INTRODUCTION

• Use the readily inserted SCREWDRIVER stylet. (Push the screwdriver stylet into the helix.)
• Make sure the helix is retracted all the way into the lead. Hold the lead still and turn the screwdriver stylet 3+ turns counterclockwise. After 4 turns you will feel a clicking sensation. This is the action of the clutch protecting the helix while retracting completely. More than 4 turns counterclockwise will not damage the clutch action.
• While holding the lead and the fully inserted stylet as one assembly - continue to introduce the lead.

FOR FIXATION OF THE HELIX
When you are ready to FIX the lead:

• make sure to use the SCREWDRIVER stylet
• and that the helix is completely retracted,
• and that the stylet is STRAIGHT (a BENT screwdriver stylet will not turn the helix - replace it with the spare screwdriver stylet provided in the package.)
• Turn the stylet CLOCKWISE while holding the lead still. (Turn only 3 turns. Turning more than 3 turns CLOCKWISE will damage the helix.)

Caution - Stylet Usage on POLYURETHANE Insulated ZY Atrial/Ventricular Leads

Do not force the stylet handle onto the terminal pin, especially on a polyurethane lead. Polyurethane leads do not stretch as easily as silicone leads. When performing this procedure should you feel a considerable amount of resistance, this is an indication that the tip of the stylet has already reached the screw tip mechanism and no additional force is required. The use of excessive force on the screwdriver stylet when fully inserted, may impair or alter the extension and/or retraction of the helix (screw).

Stylets For All ZY Leads

1. All ZY leads are packaged with three screwdriver stylets and one regular stylet.
   a. Blue handled flexible screwdriver stylets are packaged with the ZY-J leads. The flexibility of this stylet is needed to form the J curve.
   b. White handled screwdriver stylets are packaged with the ZY straight leads, used for the ventricular placement or atrial wall placement.
   c. Red handled stylets are a non-screwdriver stylet for the lead introduction.
2. The handle of all screwdriver stylets are intended to be pushed down over the terminal pin to ensure the screwdriver tip reaches the helix. Due to tolerance levels, the stylet handle will not always completely cover the terminal pin. NOTE: excessive force is not necessary and may damage the helix.
3. When the stylet handle covers the lead terminal pin, threshold cables can be hooked onto the metal side pin of the stylet handle for threshold measurements. NOTE: do not loosen this metal side pin, as it may render the stylet inoperable.
4. All screwdriver stylets should remain free of any kinks or bends, and kept as clean as possible before introduction in order to function properly.