Bipolar lumenless lead performance in children and adults with congenital heart disease.
BACKGROUND
Because of small size and anatomic variation, implantation of intracardiac leads for permanent pacing in pediatric and congenital heart disease (CHD) patients can be challenging. A novel 4.1F bipolar catheter-delivered lead offers potential advantages for this population. OBJECTIVE; The purpose of this study was to retrospectively evaluate this lead performance in this specific population.


METHODS
We performed a retrospective descriptive analysis of all pediatric and adult CHD patients at a single center implanted with a 4.1F bipolar catheter-delivered active fixation pacemaker lead (Medtronic model 3830, Medtronic, Inc, Minneapolis, MN, USA).


RESULTS
Over 10 months, 42 leads were implanted in 27 patients. Twenty-six atrial and 16 ventricular leads were placed. Patient ages were 1-28 years (mean 15 +/- 7), and weights were 7.8-104 kg (mean 51.5 +/- 26.6). Ventricular septal defect and D-transposition of great arteries were the most prevalent CHD diagnoses. Implant capture thresholds were 1.2 +/- 0.8 V at 0.5 ms in the atrium and 0.8 +/- 0.5 V at 0.5 ms in the ventricle. Implant sensing thresholds were 4.1 +/- 2.7 mV in the atrium and 12.1 +/- 4.9 mV in the ventricle. Phrenic nerve stimulation was avoided in all, and selective site pacing was achieved in most cases. Pacing and sensing thresholds remained stable during 90 +/- 52 days follow-up. No lead related complications, failures, or extractions were observed.


CONCLUSIONS
In our single-center experience with pediatric and CHD patients, a novel small, catheter-delivered bipolar lead has proven safe and effective for atrial and ventricular pacing in acute and subacute time periods. Longer performance trends will be required to determine chronic efficacy.
Daccarett
Marcos
M
Division of Cardiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84158, USA.
Segerson
Nathan M
NM
Bradley
David J
DJ
Etheridge
Susan P
SP
Freedman
Roger A
RA
Saarel
Elizabeth Vickers
EV
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004567:Electrodes, Implanted; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000628:therapy; D055815:Young Adult