Premium
Five‐Year Follow‐Up of a Bipolar Steroid‐Eluting Ventricular Pacing Lead
Author(s) -
SCHWAAB BERNHARD,
FRÖHLIG GERD,
BERG MONIKA,
SCHWERDT HOLGER,
SCHIEFFER HERMANN
Publication year - 1999
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.1540-8159.1999.tb00604.x
Subject(s) - medicine , lead (geology) , ventricular pacing , cardiology , nuclear medicine , anesthesia , heart failure , geomorphology , geology
Steroid‐eluting pacing leads are known to attenuate the threshold peaking early after implantation. Long‐term performance, however, is not yet settled. The lead design tested in this prospective study combines a 5.8‐mm 2 tip of microporous platinum‐iridium with elution of 1.0 mg of dexamethasone sodium phosphate and tines for passive fixation (model 5024, Medtronic Inc.). In 50 patients (mean age 69 ± 10 years), the electrode was implanted in the right ventricular apex. Follow‐up was performed on days 0, 2, 5, 10, 28, 90, 180 and every 6 months thereafter for 5‐years postimplant. At each visit, pacing thresholds were determined as pulse duration (ms) at 1.0 V and as the minimum charge (μC) delivered for capture. Lead impedance (Ω) was telemetered at 2.5 V‐0.50 ms, and sensing thresholds (mV) were measured in triplicate using the automatic sensing threshold algorithm of the pacemaker implanted (model 294–03, Intermedics Inc.). On the day of implantation, mean values were 0.10 ± 0.03 ms, 0.12 ± 0.03 μC, 758 ± 131 Ω, and 13.1 ± 1.8 mV, respectively. Beyond 1‐year postimplant, pacing thresholds did not vary significantly. Sensing thresholds and lead impedance values were stable during long‐term follow‐up. Five years after implantation, mean values were 0.23 ± 0.11 ms, 0.24 ± 0.07 μC, 670 ± 139 Ω, and 11.6 ± 3.1 mV for pulse width and charge threshold, lead impedance, and sensing threshold, respectively, and all leads captured at 1.0 V with the longest pulse duration available (1.50 ms). It is concluded that the bipolar steroid‐eluting tined ventricular lead showed stable stimulation thresholds, lead impedance values, and sensing thresholds for 5 years after implantation.