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Improved Epimyocardial Pacing : Initial Experience with a New Bipolar, Steroid‐Elnting, High Impedance Lead Design
Author(s) -
KARPAWICH PETER P.,
STOKES KENNETH B.,
PROCTOR KEITH,
SCHALLHORN RICK,
McVENES RICHARD,
FACTKOR MATHEW
Publication year - 1994
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.1540-8159.1994.tb03795.x
Subject(s) - medicine , implant , lead (geology) , high impedance , cardiology , electrical impedance , biomedical engineering , surgery , electrical engineering , engineering , geomorphology , geology
Epicardial pacing typically is associated with decreased pacing and sensing capabilities compared with the endocardial approach. Since endocardial pacing is neither appropriate nor possible in all instances, this study was conducted to evaluate a new concept in a chronic epimyocardial lead design in six 3‐month‐old growing dogs. The new bifurcated lead (Medtronic model 10401) is a low current drain, high impedance, steroid‐eluting, bipolar design. The implant is facilitated by a suture attached with an atraumatic needle. Twelve ventricular leads were implanted (2 per animal) and followed for 6 months with weekly analysis of pacing and sensing capabilities. Results at explant were compared with implant values. There were no significant differences between implant and explant in sensed R waves, or in the slew rate of the R wave in unipolar or bipolar modes. Lead impedances at explant remained high in both modes: bipolar, 1550 ± 223; unipolar, 1234 ± 262 Ω (P < 0.05). Chronic voltage (v) threshold at 0.5 msec showed no significant change from implant values during the study: unipolar, 0.4 ± 0.2 vs 0.7 ± 0.3; bipolar, 0.5 ± 0.4 vs 1 ± 0.5. Histologic evaluations of the electrode tissue interface demonstrated negligible fibrotic capsule formation. This study introduces a new, easily implanted, high impedance, low threshold, bipolar epimyocardial pacing lead design with excellent chronic pacing and sensing characteristics.