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Steroid‐Tipped Leads Versus Porous Platinum Permanent Pacemaker Leads: A Controlled Study
Author(s) -
WISH MARC,
SWARTZ JOHN,
COHEN ANDREW,
COHEN ROBERT,
FLETCHER ROSS
Publication year - 1990
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.1540-8159.1990.tb06910.x
Subject(s) - medicine , implant , cardiology , platinum , pulse (music) , significant difference , surgery , voltage , biology , biochemistry , physics , quantum mechanics , catalysis
WISH, M., ET AL.: Steroid‐Tipped Leads Versus Porous Platinum Permanent Pacemaker Leads: A Controlled Study. There is little data directly comparing steroid‐tipped permanent pacemaker leads to otherwise state‐of‐the‐art porous platinum leads. Eighteen patients receiving unipolar generators capable of low voltage outputs were randomized at the time of implant to receive either steroid‐tipped leads or porous platinum leads. All leads were unipolar, tined, passive fixation, and placed in the right ventricular apex or atrial appendage. This study is single center. At implant, threshold pulse width was determined at 3 voltages (2.5, 1.5, and 0.8 V). Follow‐up thresholds were determined at weeks 1, 2, 3, and 4, and at 3 and 6 months. There was no difference in implant thresholds or amplitudes for sensing. By 2 weeks postimplant, lower thresholds were noted for the steroid leads, and this discrepancy grew more significant with time. There was no significant postimplant rise in threshold for steroid‐tipped leads. At 6 months, the average threshold pulse width for ventricular steroid leads at 0.8 V was 0.3 ± 0.1 msec. In contrast, five patients with standard leads did not capture at maximum pulse width at 0.8 V (p < 0.0001). There was no significant difference in the amplitude of the chronic atrial electrogram. This study shows steroid‐tipped leads to offer a significant advantage in reducing thresholds early postimplant and chronically.