title: Early follow-up of lead performance in atrioventricular sequential systems.
abstract: Recent developments in pacemaker technology led us to report our initial and follow-up assessment of atrioventricular (A-V) sequential systems in 50 consecutive patients. Primary indications for pacing were sinus node dysfunction or A-V block. Leads were introduced through the subclavian vein. Atrial J-tined leads (27 silicone, 19 urethane) were positioned in the atrial appendage or stump in 46 patients, and coronary sinus or Bisping leads were placed in 4 patients; all 50 patients had tined ventricular leads. A Medtronic 5992 generator was placed in 35 patients and an Intermedics 259-01 generator in 15. Median implantation time was 105 minutes. Complications requiring reoperation in 409 patient-months of follow-up included lead retraction (one patient), phrenic nerve stimulation (one), pseudofracture (one), and atrial lead-induced "cross talk" (one). Monthly telephone transmission confirmed atrial capture in 35 patients and loss of capture in 1; the remainder had no identifiable P wave. Ventricular capture was confirmed in all. Postimplant and follow-up checks showed good stability of lead positions. We conclude that these systems have a low incidence of problems in short-term follow-up.
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D001919:Bradycardia / Q000628:therapy; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology*; D006327:Heart Block / Q000628:therapy; D006339:Heart Rate; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013575:Syncope / Q000628:therapy; D013610:Tachycardia / Q000628:therapy