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Straight Screw‐In Atrial Leads “J‐Post Shaped” in Right Appendage Versus J‐Shaped Systems for Permanent Atrial Pacing: A Safety Comparison
Author(s) -
ZOPPO FRANCO,
ZERBO FRANCESCA,
BRANDOLINO GLAUCO,
BACCHIEGA ENRICO,
LUPO ANTONIO,
BERTAGLIA EMANUELE
Publication year - 2011
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.1540-8159.2010.02986.x
Subject(s) - medicine , appendage , cardiology , atrial appendage , atrial fibrillation , anatomy , sinus rhythm
Background and Objectives: The reliability of active‐fixation atrial leads has been compared with that of passive‐fixation leads; comparisons have also been made between straight and J‐shaped screw‐in lead systems. However, few data are available on procedural and short‐term safety. This retrospective study compared the procedural safety of non‐pre‐shaped screw‐in leads with that of passive‐ and active‐fixation J‐shaped leads.Patients and Methods: From January 2004 to January 2010, 1,464 patients underwent new pacemaker/implantable cardioverter‐defibrillator implantation. Of these, 915 (study population) received a passive‐ or active‐fixation pre‐J‐shaped lead, or a straight screw‐in atrial lead; the remaining 549 patients, who received only a ventricular lead, were excluded. The three study groups were: Group S‐FIX (165 patients, 18%), receiving a straight screw‐in atrial lead (postshaped in the right appendage); Group J‐PASS (690 patients, 75.4%), receiving a passive‐fixation J‐shaped atrial lead; and Group J‐FIX (60 patients, 6.6%), receiving an active‐fixation screw‐in J‐shaped atrial lead.Procedural and short‐term complication rates were analyzed up to 3 months postimplantation.Results: One complication occurred in each group (S‐FIX 0.6% vs J‐PASS 0.1% vs J‐FIX 1.6%, P = 0.3, 0.1, and 0.4, respectively, for each comparison). The rate of atrial lead dislodgement was higher in Group J‐PASS than in S‐FIX but not J‐FIX (Group S‐FIX 0 vs Group J‐PASS 16 vs Group J‐FIX 1 dislodgements; P = 0.04 and 0.7, respectively).Conclusion: Straight screw‐in atrial leads, “J‐post shaped” in the right appendage, offer better stability than passive‐fixation J‐shaped leads and display a similarly acceptable safety profile compared with both the J‐shaped systems. (PACE 2011; 34:325–330)