Chronic ventricular electrograms: do steroid-eluting leads differ from conventional leads?
The aim of steroid-eluting leads is to reduce chronic pacing thresholds. Whether steroid-eluting leads also modify acute and chronic R wave amplitudes as well as R wave sensing of the pulse generator was investigated in 31 patients with a unipolar ventricular pacemaker. Four different leads were implanted: Two steroid-eluting leads with different electrode surface areas (8 mm2 and 5.8 mm2) and two conventional leads (Target Tip, Elgiloy lead). At implantation filtered R wave amplitudes, peak-to-peak values, and slew rates were measured by a pacing system analyzer. One year after implantation R wave amplitudes were directly determined from intracardiac electrograms and compared to the peak-to-peak data at implantation. Additionally, R wave inhibition was evaluated at a sensitivity setting of 5 mV. There were no differences among the four leads in respect to any of the parameters studied at implantation. At follow-up, no differences in R wave amplitudes were found leading to an appropriate sensing in all leads. Steroid-eluting leads did not differ from conventional leads and a smaller electrode surface area of 5.8 mm2 had no influence on ventricular electrogram. Together with a pacemaker with an input impedance of 37 kohms R wave sensing was a correct setting of 5 mV.
Schuchert
A
A
Department of Cardiology, University Hospital Eppendorf, Hamburg, West Germany.
Hopf
M
M
Kuck
K H
KH
Bleifeld
W
W
D000368:Aged; D000497:Alloys; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D004553:Electric Conductivity; D004562:Electrocardiography; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D006047:Gold Alloys; D006352:Heart Ventricles; D006801:Humans; D007495:Iridium; D008297:Male; D010138:Pacemaker, Artificial; D010984:Platinum; D012828:Silicones; D013499:Surface Properties; D013997:Time Factors; D014025:Titanium
D000497:Alloys; D004343:Drug Implants; D006047:Gold Alloys; D012828:Silicones; D007495:Iridium; D010984:Platinum; D003907:Dexamethasone; D014025:Titanium