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Comparison of Mid‐term Clinical Experience with Steroid‐Eluting Active and Passive Fixation Ventricular Electrodes in Children
Author(s) -
CEVIZ NACI,
ÇELIKER ALPAY,
KÜÇÜKOSMANOĞLU OSMAN,
ALEHAN DURSUN,
KILIÇ AYHAN,
ÜNER ABDURRAHMAN,
ÖZME SENCAN
Publication year - 2000
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.1540-8159.2000.tb00938.x
Subject(s) - medicine , fixation (population genetics) , lead (geology) , cardiology , surgery , population , environmental health , geomorphology , geology
Although active fixation ventricular leads seem to have advantages over passive fixation leads, this study compares the follow‐up results of active and passive fixation leads in children. We evaluated the implantation and follow‐up data of 41 children with active (Ac‐cufix II DEC, group 1) (n = 20) or passive (Membrane E, group 2) (n = 21) fixation, steroid‐eluting ventricular leads. All but one of the patients in group 1 completed the 12‐month follow‐up. The mean follow‐up period in group 2 was 10.4 ± 2.9 months (range 3–12 months, median 12 months). In both groups the mean pacing threshold was measured as 0.51 ± 0.09 V versus 0.48 ± 0.15 V (P > 0.05) at 0.5‐ms pulse width, mean R wave amplitude as 9.9 ± 2.5 m V versus 9.4 ± 3.2 mV (P > 0.05), and mean impedance as 557 ± 92 Ω versus 664 ± 160 Ω (P < 0.05), respectively, at implantation. After the first week of pacing, mean threshold values in group 1 were significantly lower than those of group 2 (P < 0.01 and P < 0.05, respectively). During the follow‐up period, lead impedance measurements did not show a significant difference between the two groups. In one patient from group 1, the lead (by unscrewing) was removed easily because of pacemaker pocket infection. No lead dislodgement or helix deformation occurred in group 1. Nevertheless, in one patient from group 2, the lead was extracted at 4‐month postimplantation because of lead displacement. We conclude that the steroid‐eluting active fixation lead (Accufix II DEC) have advantages of easier implantation and lower acute and chronic stimulation thresholds compared to the passive fixation lead (Membrane E). Therefore, Accufix II DEC is superior to Membrane E, and it is a better first choice in children with an implanted single chamber ventricular pacemaker.