Steroid-eluting epicardial leads in pediatrics: improved epicardial thresholds in the first year.
From 1986 to 1991, we evaluated the clinical use of three new epicardial lead designs incorporating a steroid-eluting electrode. Medtronic models SP2114 (bipolar high profile), 10320 (bipolar low profile), 10295A/4965 (unipolar low profile) steroid epicardial (SE) leads were used on either atrium or ventricle for a total of 21 lead placements in 17 patients. Energy thresholds (T) were calculated and compared with our most recent 16 nonsteroid epicardial (NE) Medtronic model 4951 lead implants for which T was available. SE leads demonstrated no acute T rise and continued T improvements at 1 year of follow-up. We conclude that epicardial application of SE lead technology offers a major improvement in pacing lead function and potential pacemaker longevity over NE leads in pediatric patients in whom endocardial pacing is precluded by size or anatomy.
Hamilton
R
R
Division of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Gow
R
R
Bahoric
B
B
Griffiths
J
J
Freedom
R
R
Williams
W
W
D000818:Animals; D002304:Cardiac Pacing, Artificial / Q000379:methods; D002648:Child; D003907:Dexamethasone; D004285:Dogs; D004553:Electric Conductivity; D004567:Electrodes, Implanted; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D010138:Pacemaker, Artificial; D010496:Pericardium
D003907:Dexamethasone