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Atrial Pacing Leads: The Clinical Contribution of Steroid Elution
Author(s) -
MOND HARRY G.,
HUA WEI,
WANG CHUN CHIEH
Publication year - 1995
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.1540-8159.1995.tb06981.x
Subject(s) - medicine , fixation (population genetics) , lead (geology) , implant , cardiology , surgery , population , environmental health , geomorphology , geology
MOND, H.G., et al .: Atrial Pacing Leads: The Clinical Contribution of Steroid Elution . Although the original atrial pacing leads were passive fixation and J shaped for right atrial appendage placement, the subsequent development of the active fixation screw‐in lead found favor because of a perceived low incidence of lead dislodgment and a wider selection of atrial pacing sites. A bipolar atrial lead study was undertaken to compare the long‐term atrial implant data in 215 patients. Study leads comprised one passive fixation, steroid‐eluting lead (Medtronic CapSure ® SP, 119 patients) and three nonsteroid‐eluting leads; two active fixation (Medtronic BISPING ® model 4058, 30 patients; and Telectronics ACCUFIX ® model 330–801, 44 patients) and one passive fixation (Telectronics ENCOR ® model 330–854, 22 patients). Bipolar atrial voltage stimulation thresholds and electrograms were measured using the Telectronics META ® DDDR immediately postimplantation, and at 1‐, 3‐, 6‐, 12‐, and 18‐month follow‐up. There were 135 males and the mean age 68 years. The incidence of lead dislodgment was 4% for active fixation and 2% for passive fixation. All nonsteroid leads showed a typical rise in stimulation threshold with the highest being the ACCUFIX followed by the BISPING and ENCOR. The steroid‐eluting CapSure SP, however, demonstrated a flat response with 98% of leads at 18 months having a value ≤ 1.3 volts allowing voltage programming to 2.5 volts (2:1 safety ratio). Telemeted electrograms showed no differences for all leads at all visits. For low voltage atrial pacing with a low incidence of dislodgment and satisfactory atrial sensing, the steroid‐eluting passive fixation lead is superior to all nonsteroid‐eluting leads.