Clinical evaluation of a single-pass implantable electrode for all modes of pacing. The "Crown of Thorns" lead.
Physiological pacing was instituted in 17 patients (11 men and 6 women), mean age 67 years (range 33-77 years), using a variety of multiprogramable generators attached to a permanent single-pass dual chamber electrode. Eleven patients were paced in VAT mode (Cordis 208A or Siemens-Elema 625 generator), two patients in DVI mode (Intermedics Cyberlith IV generator) and four patients in DDD mode (Siemens-Elema 664/P33 or Telectronics Autima unit). Mean intracardiac P wave amplitude was 2.0 mV +/- 0.78/SD, range 0.7-3.6 mV. and mean atrial and ventricular pacing thresholds were 1.0 V and 0.5 V, respectively. Fourteen patients had completely successful A-V pacing during a follow-up period of 4-13 months (mean 7 +/- 2.7 months). Two failures were associated with malposition of the atrial crown and occurred exclusively with the Cordis 208A generator. In both patients generator replacement using a more sensitive unit (Siemens-Elema 625) resulted in successful VAT pacing for most of the time. Complete failure of A-V pacing occurred in only one patient who died from coronary artery disease after four months of follow-up. Thus, all of the remaining 16 patients achieved long-term (6 months) satisfactory physiological pacing using this new lead. We conclude that the "Crown of Thorns" electrode is a successful single-pass unipolar lead and can be used with all types of dual chamber generator for all modes of pacing.
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000628:therapy; D013610:Tachycardia / Q000188:drug therapy / Q000628:therapy; D014700:Verapamil / Q000627:therapeutic use
D014700:Verapamil