title: [Prerequisites for pacemaker electrodes for individual programming of a low stimulation impulse (comparison of an Elgiloy and a steroid-dependent pacemaker electrode)].
abstract: The individual programming of cardiac pacemakers to pulse amplitudes of 2.5 volts and less reduces unnecessary energy consumption by the pacing impulse. In order not to impair the safety margin, electrodes must reveal a low chronic pacing threshold associated with a small standard deviation. For 3 months after implantation we investigated these conditions in 10 patients with a steroid-eluting lead and in 10 patients with a conventional elgiloy lead. During the study period patients with a steroid-eluting lead had a significantly lower pacing threshold. Twelve weeks after implantation all steroid-patients had 0.8 volts pacing threshold at 0.5 ms pulse width. In contrast to the conventional lead the steroid-eluting lead had a significantly lower impedance. Since voltage enters squared into the energy consumption formula, patients with a steroid-eluting lead needed significantly less energy for an effective stimulation of the myocardium 4 and 12 weeks after implantation. R-wave amplitude was not different in both groups. Our investigation demonstrates that immediately after implantation all patients with a steroid-eluting lead can be programmed at 2.5 volts pulse voltage or individually even lower. The saved energy results either in an extended pulse generator longevity or allows the implantation of a smaller pulse generator with a reduced battery capacity.
authors.affiliation: Abteilung Kardiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
authors.forename: A
authors.initials: A
authors.lastname: Schuchert
authors.forename: K H
authors.initials: KH
authors.lastname: Kuck
authors.forename: W
authors.initials: W
authors.lastname: Bleifeld
mesh_terms: D000368:Aged; D001919:Bradycardia / Q000628:therapy*; D003907:Dexamethasone; D004562:Electrocardiography / Q000295:instrumentation; D004567:Electrodes, Implanted; D005260:Female; D006327:Heart Block / Q000628:therapy; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000628:therapy; D012815:Signal Processing, Computer-Assisted; D012984:Software
chemical_list: D003907:Dexamethasone
vernacular_title: Voraussetzungen von Schrittmacherelektroden für die individuelle Programmierung eines niedrigen Stimulationsimpulses (Vergleich einer Elgiloy- und einer steroidabgebenden Schrittmacherelektrode).