Multi-center clinical experience with a lumenless, catheter-delivered, bipolar, permanent pacemaker lead: implant safety and electrical performance.
OBJECTIVE
Reduced lead diameter and reliability can be designed into transvenous permanent pacing leads through use of redundant insulation and removal of the stylet lumen. The model 3830 lead (Medtronic Inc., Minneapolis, MN, USA) is a bipolar, fixed-screw, steroid-eluting, lumenless, 4.1-Fr pacing lead. Implantation can be performed in a variety of right heart sites using a deflectable catheter (Model 10600, Medtronic). Lead performance and safety were studied.


METHODS
Two prospective trials of 338 implanted subjects from 56 global sites were conducted. Electrical and safety data were obtained at implant, pre-discharge, and up to 18 months post-implant. Leads were implanted at traditional and alternate right heart sites.


RESULTS
The study enrolled 338 subjects (204 males, 70.6 +/- 11.6 years) followed-up for a mean of 10.2 months (range, 0-21.6). Mean P-wave amplitudes ranged from 3.2 mV at 3 months to 2.9 mV at 18 months, while mean atrial pulse width thresholds at 2.5 V ranged from 0.07 ms at 3 months to 0.09 ms at 18 months. Mean R-wave amplitudes ranged from 11.3 mV to 11.1 mV and mean ventricular pulse width thresholds at 2.5 V ranged from 0.10 ms to 0.14 ms. There were 22 ventricular and 12 atrial lead complications within 3 months post-implant. Survival from lead-related complications improved to a clinically acceptable rate in the cohort of patients when revised implant techniques were employed.


CONCLUSIONS
With the use of recommended implant techniques, the study results support the electrical efficacy and safety of a catheter-delivered, lumenless lead in traditional or alternate right atrium or right ventricle sites through 18 months post-implant.
Gammage
Michael D
MD
Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK.
Lieberman
Randy A
RA
Yee
Raymond
R
Manolis
Antonis S
AS
Compton
Steven J
SJ
Khazen
César
C
Schaaf
Katie
K
Oleson
Kimberly A
KA
Crossley
George H
GH
D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000706:statistics & numerical data*; D004567:Electrodes, Implanted / Q000706:statistics & numerical data*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004869:Equipment Safety / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology