title: Unsatisfying results in long-term atrial pacing with a bipolar active fixation atrial lead.
abstract: A high dislodgment rate during long-term atrial pacing using the unipolar sickle-shaped active fixation lead was recently reported; therefore, the long-term results of atrial pacing in 118 consecutive patients with the bipolar sickle-shaped active fixation lead (Biotronik FH60-BP) were evaluated. Between January 1989 and September 1993, 87 leads (74%) were inserted for dual chamber pacing and 31 leads (26%) for atrial pacing only. At the time of implantation, the bipolar atrial electrogram had a mean voltage of 4.4 +/- 1.6 mV, whereas the acute atrial threshold was 0.72 +/- 0.38 V and 1.46 +/- 0.67 mA at 0.5-msec pulse duration and mean resistance 506 +/- 79 omega. Early lead dislodgment (< 1 month after implantation) occurred in 9 patients (7.6%). During a mean follow-up of 21.8 months (median 20.9 months), late dislodgment (> 1 month after implantation) occurred in 6 patients (5.1%) after a mean interval of 7.9 months (range 3-14 months). Due to the unacceptably high late dislodgment rate, which to date remains unexplained, new implants of this lead are not recommended.
authors.affiliation: Department of Cardiology and Cardiac Pacing, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Buys
authors.forename: N M
authors.initials: NM
authors.lastname: van Hemel
authors.forename: J C
authors.initials: JC
authors.lastname: Kelder
authors.forename: P F
authors.initials: PF
authors.lastname: van Dessel
authors.forename: L
authors.initials: L
authors.lastname: Bakema
mesh_terms: D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006327:Heart Block / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D012804:Sick Sinus Syndrome / Q000628:therapy