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Comparison of the Medtronic SelectSecure and conventional pacing leads: Long‐term follow‐up in a multicenter pediatric and congenital cohort
Author(s) -
Moak Jeffrey P.,
Law Ian H.,
LaPage Martin J.,
Fish Frank,
Shatty Ira,
Dubin Anne M.,
Patel Akash,
Fishbach Peter,
Cain Nicole,
Johnsrude Christopher,
Berul Charles I.,
Bangoura Aminata,
Hanumanthaiah Sridhar,
McCarter Robert
Publication year - 2019
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/pace.13614
Subject(s) - medicine , cohort , cardiology , lead (geology) , ventricular pacing , heart disease , heart failure , geomorphology , geology
The Medtronic SelectSecure™ (Minneapolis, MN, USA) pacing lead (SS) has theoretical advantages compared to conventional (C) transvenous pacing leads (PLs). The study purpose was to determine whether differences in electrical function and lead survival exist between these PLs in a large data set of pediatric and congenital patients. Methods A multicenter historical longitudinal cohort study was performed comparing SS and CPL performance over a 72‐month follow‐up (FU). Ten centers provided data for both SS and CPL, matched for age, implanted pacing chamber, time period of implantation, and presence of heart disease. Results The cohort consisted of 141 subjects in each group. No statistical differences were observed in age, gender, presence of heart disease, or pacing indication. Atrial and ventricular capture thresholds were stable throughout FU and higher in the SS group (atrial: 0.75 ± 0.02 vs 0.5 ± 0.04 V, ventricular: 1.0 ± 0.04 vs 0.75 ± 0.04 V), P < 0.001. Group PL sensing thresholds did not differ. The SS group required greater energy to pace (atrial: 0.57 ± 0.05 vs 0.32 ± 0.02 mJ, ventricular: 0.83 ± 0.05 vs 0.56 ± 0.06 mJ), P = 0.001. Early lead dislodgement and phrenic nerve stimulation were greater in the SS group (P = 0.03). Long‐term lead survival was high and similar between the two groups, P = 0.35. Conclusions Long‐term survival of both PL was high with a low fracture rate. The SS had excellent electrical function but did show higher capture thresholds and increased energy to pace; these differences are offset by other advantages of the SS PL.