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Randomized Comparison of J‐Shaped Atrial Leads with and without Active Fixation Mechanism
Author(s) -
LURIA DAVID M.,
FEINBERG MICHA S.,
GUREVITZ OSNAT T.,
BARLEV DAVID S.,
GRANIT CHAVA,
TANAMI NECHEMIA,
ELDAR MICHAEL,
GLIKSON MICHAEL
Publication year - 2007
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.1540-8159.2007.00683.x
Subject(s) - medicine , mechanism (biology) , cardiology , fixation (population genetics) , population , environmental health , philosophy , epistemology
Background: In this prospective, randomized, controlled study, we compared the performance of J‐shaped active fixation (AF) atrial leads with J‐shaped passive fixation (PF) leads, over a 1‐year follow‐up period.Methods: A total of 200 consecutive patients were prospectively randomized for implantation with a Medtronic 5568 AF lead model (n = 103; Minneapolis, MN, USA) versus a Medtronic 5592 PF model (n = 97), and all lead‐related measurements and complications were recorded over one year.Results: All leads were successfully implanted with a nonsignificant difference in crossover rate to the alternative lead due to failed implantation (1 in the AF and 4 in the PF group, P = NS). Fluoroscopy time during implantation procedure was significantly shorter in the PF group (2.1 ± 3.6 vs 3.3 ± 4.5 minute, P < 0.05). Pacing thresholds during implantation were significantly lower in patients with PF leads (0.7 ± 0.3 V vs 0.9 ± 0.3 V, P < 0.001) and this difference persisted at 1‐year follow‐up (0.8 ± 0.6 V vs 1.3 ± 0.9 V in PF and AF leads respectively, P < 0.05). Lead‐related complications occurred in PF and AF with similar frequency (4% and 9% respectively, P = 0.2). However, pericardial complications occurred only in the AF group (6 cases, P = 0.01). Lead dislodgement was observed in only two cases—both in the PF group (P = 0.3).Conclusion: Both types of J‐shaped atrial leads had reasonable performance. PF leads required shorter fluoroscopy time for implantation, demonstrated a better pacing threshold over a 1‐year follow‐up period and had no pericardial complications, while AF lead implantation was complicated by pericardial irritation and/or effusion in 6% cases (P = 0.01).