Initial experience with a co-radial bipolar pacing lead.
A new type of endocardial bipolar pacing lead has been designed to overcome the potential drawbacks of the conventional coaxial bipolar pacing lead. We prospectively evaluated the new co-radial bipolar pacing leads (Intermedics Thin-Line), which are thinner (5 Fr vs 6-8 Fr) than standard coaxial bipolar leads. X-ray visibility and lead handling were subjectively assessed (excellent, good, adequate, or poor) at implant; lead impedance, sensitivity threshold, and pacing threshold were measured at implant, then at 1, 3, 6, 12, and 18 months. The results were as follows: 103 patients (51 M; age 63.8 +/- 17.4 years) received 71 atrial (A) and 89 ventricular (V) leads. X-ray visibility was excellent in 59/103; good in 23/103; adequate in 11/103; and poor in 10/103. Overall handling was excellent in 56/71 A and 69/89 V; good in 11/71 A and 18/89 V; adequate in 3/71 A and 1/89 V; poor in 1/71 A and 1/89 V. There were two perioperative complications. At implant: impedance in A and V were 370.1 +/- 74.7 and 501.5 +/- 124.4 omega, sensing thresholds in A and V were 3.0 +/- 1.5 and 9.9 +/- 5.0 mV, pacing thresholds at 0.45 ms in A and V were 0.59 +/- 0.21 and 0.41 +/- 0.15 volt, respectively. At 1, 3, 6, 12, and 18 months of follow-up: no pacing lead related complications were reported; pacing lead characteristics remained outstanding and stable. This new lead appears to have significant clinical advantages over the conventional coaxial bipolar pacing lead. Long-term follow-up is required to confirm its reliability and chronic performance characteristics.
Tang
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Department of Medicine, University of British Columbia, Vancouver Hospital and Health Sciences Centre (UBC and Oak Street Sites), Canada.
Yeung-Lai-Wah
J A
JA
Qi
A
A
Mills
P
P
Clark
J
J
Tyers
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy; D001919:Bradycardia / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods; D004553:Electric Conductivity; D017097:Electric Impedance; D004567:Electrodes, Implanted / Q000009:adverse effects; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006327:Heart Block / Q000628:therapy; D006352:Heart Ventricles; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012804:Sick Sinus Syndrome / Q000628:therapy; D013499:Surface Properties; D013610:Tachycardia / Q000628:therapy