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Implantation of a Dual Chamber Pacing and Sensing Single Pass Defibrillation Lead
Author(s) -
GRADAUS RAINER,
BLOCK MICHAEL,
DORSZEWSKI ANJA,
SCHRIEVER CHRISTOPH,
HAMMEL DIETER,
SCHELD HANS H.,
BORGGREFE MARTIN,
BREITHARDT GÜNTER,
BÖCKER DIRK
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.00416.x
Subject(s) - medicine , defibrillation , cardiology , lead (geology) , ventricle , defibrillation threshold , implant , single chamber , ventricular pacing , perioperative , atrium (architecture) , anesthesia , atrial fibrillation , heart failure , surgery , geomorphology , geology
GRADAUS, R., et al. : Implantation of a Dual Chamber Pacing and Sensing Single Pass Defibrillation Lead. Dual‐chamber ICDs are increasingly used to avoid inappropriate shocks due to supraventricular tachycardias. Additionally, many ICD patients will probably benefit from dual chamber pacing. The purpose of this pilot study was to evaluate the intraoperative performance and short‐term follow‐up of an innovative single pass right ventricular defibrillation lead capable of bipolar sensing and pacing in the right atrium and ventricle. Implantation of this single pass right ventricular defibrillation lead was successful in all 13 patients ( age 63 ± 8 years ; LVEF 0.44 ± 0.16 ; New York Heart Association [NYHA] 2.4 ± 0.4 , previous open heart surgery in all patients). The operation time was 79 ± 29 minutes, the fluoroscopy time 4.7 ± 3.1 minutes. No perioperative complications occurred. The intraoperative atrial sensing was 1.7 ± 0.5 mV , the atrial pacing threshold product was 0.20 ± 0.14 V/ms ( range 0.03–0.50 V/ms ). The defibrillation threshold was 8.8 ± 2.7 J . At prehospital discharge and at 1‐month and 3‐month follow‐up, atrial sensing was 1.9 ± 0.9, 2.1 ± 0.5, and 2.7 ± 0.6 mV , respectively, ( P = NS, P < 0.05, P < 0.05 to implant, respectively), the mean atrial threshold product 0.79, 1.65, and 1.29 V/ms , respectively. In two patients, an intermittent exit block occurred in different body postures. All spontaneous and induced ventricular arrhythmias were detected and terminated appropriately. Thus, in a highly selected patient group, atrial and ventricular sensing and pacing with a single lead is possible under consideration of an atrial pacing dysfunction in 17% of patients.