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The High Impedance Dish Electrode—Clinical Experience with a New Tined Lead
Author(s) -
MOND HARRY,
HOLLEY LORAINE,
HIRSHORN MICHAEL
Publication year - 1982
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 - 10.1111/j.1540-8159.1982.tb02273.x
Subject(s) - electrode , medicine , lead (geology) , endocardium , biomedical engineering , surgery , materials science , cardiology , chemistry , geomorphology , geology
To reduce current drain and thus optimize pulse generator longevity, 25 unipolar trailing tined leads with a 6 mm 2 platinum electrode shaped as a dish were implanted in suitable patients and compared to a patient series in which 25 standard unipolar trailing tined leads with an 8 mm 2 standard platinum electrode were implanted. Comparing the two patient groups there were no significant differences in age, sex, diagnosis or vein used. Comparing implant data: mean voltage threshold was 0.50 ± 0.13 V (standard deviation) for the group with the dish electrode and 0.60 + 0.14 V for the group with the standard electrode (p < 0.02). The mean current threshold was 0.64 ± 0.18 mA for the dish electrode and 0.88 ± 0.25 mA for the standard electrode (p < 0.001). The mean calculated impedance was 758± 149 ohm for the dish electrode and 598 ± 104 ohm for the standard electrode (P < 0.001). R wave amplitude was a mean of 7.4 ± 4.3 mV (dish electrode) and 7.4 ±3.7mV (standard electrode). There were two deaths; one at twelve months, cause unknown, and the other from a postoperative hemopericardium due to right ventricular perforation from the temporary pacing lead. The only complication was an electrode retraction from the endocardium. In seven patients with dish electrodes, pulse generators able to measure voltage threshold (Vario) non‐invasively were used. Mean postoperative voltage thresholds were as follows: 24 hours 0.64 V, 48 hours 0.68 V, two weeks 1.44 V, three months 1.30 V and six months 1.40 V. Thus, at implant the lead with the dish electrode had a significantly higher impedance (21%), lower voltage threshold (17%) and lower current threshold (27%) compared to a standard lead. R wave amplitude was normal. Follow‐up voltage threshold Jevels to data suggest that lale high thresholds are unlikely. Thus, the tined lead with the high impedance dish electrode is likely both to reduce lead complications and to improve pulse generator longevity. (PACE, VoJ. 5, July‐August. 1982)