title: The electrode-tissue interface: the revolutionary role of steroid-elution.
abstract: The electrode-tissue interface is that area lying between the cathode of a low-voltage implantable pacemaker or cardioverter-defibrillator (ICD) lead and the endocardium or epi-myocardium of the cardiac chamber being paced. The electrical stimulus that is delivered to this interface is responsible for myocyte depolarization with consequent cardiac contraction. The process by which this occurs is reasonably well understood and any explanation requires a basic understanding of the physics and cellular electrophysiology of pacing. The effective and efficient delivery of electrical energy to the myocardium via the lead is dependent on many factors to be discussed in this review. However, despite numerous evolutionary changes occurring in the cathode's material, design, and surface configuration, it was not until the incorporation of steroid-elution to the electrode-tissue interface that reliable and significantly low stimulation threshold cardiac pacing became possible.
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital and Department of Medicine, the University of Melbourne, Australia.
authors.forename: Harry G
authors.initials: HG
authors.lastname: Mond
authors.forename: John R
authors.initials: JR
authors.lastname: Helland
authors.forename: Kenneth
authors.initials: K
authors.lastname: Stokes
authors.forename: Gene A
authors.initials: GA
authors.lastname: Bornzin
authors.forename: Rick
authors.initials: R
authors.lastname: McVenes
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D017147:Defibrillators, Implantable; D011211:Electric Power Supplies; D004567:Electrodes, Implanted; D004699:Endocardium / Q000166:cytology; D004867:Equipment Design; D006801:Humans; D009206:Myocardium / Q000166:cytology; D010138:Pacemaker, Artificial; D013499:Surface Properties
chemical_list: D000305:Adrenal Cortex Hormones
keywords: biomedical engineering; pacing