Active-fixation, steroid-eluting ventricular leads: the medium-term results in children.
OBJECTIVE
Low threshold characteristics and mechanical stability are important features of an ideal pacing lead, especially for children. We report our experience and medium-term results with a steroid-eluting, active-fixation ventricular lead in children.


METHODS
Telectronics Accufix II DEC model 033-212 ventricular leads were implanted in 21 patients. Eighteen patients (11 male / 7 female; 10.6+/-4.0 years), who were followed for a mean period of 6.47 +/-1.13 years, were included in the study.


RESULTS
Pacemaker mode was DDDR in three patients, and VVIR in the remaining 15 patients. Mean threshold value was 0.5 volts at implant, which increased to 0.7 volts in the first month (p>0.05). It remained stable (0.62-0.78 V) until 5.5 years (p>0.05), increased significantly at 5.5 years (0.99+/-0.63 V at 5.5 years, p<0.05) and remained significantly high after this time (p<0.05). Pacing lead impedance did not differ significantly throughout the study (p>0.05). Thirteen pulse generators reached end-of-life at > or =4 years. In all the patients whose generators were replaced (11 patients), the leads were kept in place.


CONCLUSIONS
Steroid-eluting active-fixation ventricular leads have long service lives and low chronic stimulation threshold values, allowing lower outputs. These features may have advantages in pacing therapy of children.
Ayabakan
Canan
C
Pediatric Cardiology Unit, Hacettepe University, Ihsan Doğramaci Children's Hospital, Sihhiye, Ankara, Turkey. cayabakan@yahoo.com
Celiker
Alpay
A
Karagöz
Tevfik
T
Ozer
Sema
S
Ozme
Sencan
S
D000293:Adolescent; D002304:Cardiac Pacing, Artificial / Q000379:methods* / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D004553:Electric Conductivity; D017097:Electric Impedance; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000592:standards
D020099:Coated Materials, Biocompatible