title: Long term performance of atrial leads.
abstract: Long term performance of 163 atrial leads implanted in 158 patients between July 1981 and June 1993 was evaluated. There were 122 DDD and 36 AAI units, with 125 (77%) polyurethane and 38 (23%) silicone leads. One hundred and nine (67%) unipolar and 54 (33%) bipolar leads were used. Patients were followed in the Pacemaker Clinic for 6 to 124 months (mean 50 +/- 39 months). Five patients were lost to follow up. Transient malfunction was observed in 18 cases (sensing 13, pacing 5) within the first 2 weeks. In 13 cases failure to sense subsided spontaneously and in 4 pacing malfunction could be corrected by reprogramming. Lead dislodgement occurred in 4 patients (2.5%), all within the first week. After the 1st month malfunction was uncommon. Between 1 and 12 months undersensing occurred in 4 (2.5%). In 3 cases it could be corrected by reprogramming. In the first year, reoperation was performed in 5 cases for lead related problems (3 dislodgements, 2 insulation failures). Beyond 12 months complications were as follows: failure to sense-8 (5%), failure to pace-3 (2%), insulation break -1 (0.6%). Majority of these problems could be managed by reprogramming. Reoperation was performed in 1 case with insulation break. The pacing mode had to be changed in 5 (3%) patients with dual chamber units who had loss of P wave sensing. During follow-up 98%, 98%, 96%, 95% and 83% of the leads were working satisfactorily at 1,2,3,4 and 9 years respectively. Thus atrial leads have excellent long term performance and an acceptable rate of late malfunction.
authors.affiliation: Department of Cardiology, G B Pant Hospital, New Delhi.
authors.forename: K K
authors.initials: KK
authors.lastname: Sethi
authors.forename: M
authors.initials: M
authors.lastname: Bhargava
authors.forename: J C
authors.initials: JC
authors.lastname: Mohan
authors.forename: N
authors.initials: N
authors.lastname: Pandit
authors.forename: J A
authors.initials: JA
authors.lastname: Khan
authors.forename: C S
authors.initials: CS
authors.lastname: Gokhale
authors.forename: U A
authors.initials: UA
authors.lastname: Kaul
authors.forename: R
authors.initials: R
authors.lastname: Arora
authors.forename: M
authors.initials: M
authors.lastname: Khalilullah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004567:Electrodes, Implanted; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects