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Evolution of an Active Fixation Atrial Pacing Lead
Author(s) -
SCHWAAB BERNHARD,
KINDERMANN MICHAEL,
FROHLIG GERD,
KUSCH OLIVER,
SCHIEFFER HERMANN
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.tb07021.x
Subject(s) - medicine , lead (geology) , ventricular pacing , electrode , cardiology , fixation (population genetics) , anesthesia , biomedical engineering , heart failure , population , chemistry , environmental health , geomorphology , geology
Three bipolar atrial pacing leads from one manufacturer differing in a single electrode design characteristic were compared. Each lead had nonretractable screw and a microporous electrode tip made of activated carbon. Model S84F had a tip surface area of 8 mm 2 . In model S44F, the tip surface area was reduced to 4 mm 2 by insulation of the screw, and in model BS45D, steroid elution was added to the 4 mm 2 tip. Ten patients in each group received identical pulse generators. During implantation, atrial potentials (5.4 ± 2.0, 4.2 ± 2.0, 4.6 ± 2.1 mV), pacing thresholds at 0.5 ms (0.47 ± 0.14, 0.41 ± 0.15, 0.55 ± 0.33 V) and lead impedance at 2.5 V/0.5 ms (515 ± 80, 575 ± 152, 546 ± 131 Ω) were comparable among groups. The early postoperative threshold peak was significantly lower with the BS45D than with the S84F and S44F lead models. One year after implantation, charge threshold was significantly lower with the BS45D lead than with the S84F and the S44F model (0.34 ±0.11 vs. 0.68 ± 0.20 and 0.56 ± 0.21 μC; P < 0.05). Lead impedance at 2.5 V/0.5 ms (557 ± 90, 549 ± 36, 524 ± 72 Ω) and atrial sensing (4.3 ± 2.1, 4.7 ± 1.9, 4.7 ± 0.9 mV) were not significantly different. One year postimplant, current drain of the pacing system was measured by pacemaker telemetry at chronic output settings in AAI mode/70 beats/min. Battery current measured among the three atrial lead models did not differ significantly (S84F: 11.9 ± 0.90, S44F: 12.2 ± 1.8, BS45D: 11.5 ± 0.26 μA). In conclusion: reduction of the tip surface area by insulation of the screw did not improve pacing performance. Addition of steroid elution to the 4 mm 2 tip significantly lowered the early threshold peak and the long‐term pacing threshold. Lowering of the pacing threshold, however, did not lower the current drain of the pacing system.