Bipolar Versus Unipolar Temporary Epicardial Ventricular Pacing Leads Use in Congenital Heart Disease: A Prospective Randomized Controlled Study

Mohari, Nivedita; Starr, Joanne P.; Gates, Richard N.; Domico, Michele; Batra, Anjan S.

doi:10.1111/pace.12836

Cited by 4 publications

(7 citation statements)

References 13 publications

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“…We advanced the guide-wire into the area of the old myocardial infarction for pace-mapping; therefore, the pacing threshold at the area was high. Previous reports showed that unipolar pacing threshold was lower compared with the bipolar pacing threshold [10], which was of great advantage for unipolar pacing in the present case.…”

Section: Discussionmentioning

confidence: 42%

Transcoronary mapping and chemical ablation of ventricular tachycardia in no-entry left ventricle

Kataoka

Kato

Tanaka

et al. 2019

Journal of Cardiology Cases

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Section: Discussionmentioning

confidence: 42%

Transcoronary mapping and chemical ablation of ventricular tachycardia in no-entry left ventricle

Kataoka

Kato

Tanaka

et al. 2019

Journal of Cardiology Cases

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“…Some studies investigated bipolar and unipolar leads pacing characteristics in the short-term, implying that the bipolar group had fewer sensing and pacing failure. 10,11 The probable underlying mechanism has been declared to be related to the coaxial design of Medtronic bipolar leads, which result in a lower chance of stray signal pick up and better conduction performance. 10 Furthermore, the pacing threshold illustrated to be more stable regarding bipolar steroid-eluting leads in all chambers in the longterm.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 The probable underlying mechanism has been declared to be related to the coaxial design of Medtronic bipolar leads, which result in a lower chance of stray signal pick up and better conduction performance. 10 Furthermore, the pacing threshold illustrated to be more stable regarding bipolar steroid-eluting leads in all chambers in the longterm. 2 Our finding also demonstrated that bipolar leads have better long-term pacing characteristics because of the significant rise observed in pacing threshold of unipolar leads in the right atrium and left ventricle but not regarding bipolar group and significantly greater pacing threshold of left ventricular unipolar leads at follow up.…”

Section: Discussionmentioning

confidence: 99%

A survival analysis of bipolar steroid-eluting and unipolar non-steroid-eluting epicardial leads

Fazelifar

Taghavyan

Moeini

et al. 2022

Preprint

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Background: Epicardial pacemakers are known as an alternative for endocardial pacemakers in some cases such as heart block, and complex congenital heart diseases. Considering recent advances and improvement of epicardial lead subtypes, it is essential to investigate the long-term function of them. In this study, we aimed to assess the sensing and pacing characteristics, and survival of bipolar steroid-eluting and unipolar non-steroid-eluting epicardial pacemakers. Methods: We conducted an entirely concentrated search on the documents of all patients who had undergone epicardial lead implantation in the Shaheed Rajaie Cardiovascular, Medical & Research Center during 2015-2018. Implant, and follow up data were extracted. Kaplan Meier analysis and Weibull regression hazards model were applied for the survival analysis. Results: eighty-nine leads were implanted for 77 patients. Of the total leads, 52.81%, 53.93%, and 47.19% were implanted in children (under-18-year-old), females, and patients with congenital heart diseases, respectively. Bipolar steroid-eluting leads comprised 33.71% of 89 leads. Pacing threshold of unipolar non-steroid-eluting leads that were implanted on the left ventricle and right atrium increased significantly during the follow up to greater records than bipolar steroid-eluting leads. Survival analysis also revealed that bipolar steroid-eluting leads are significantly better in 48-month survival (Weibull HR: 0.13 (95%CI, 0.02-0.99), p-value, 0.049). Age, ventricular location of the lead, and acute pacing characteristics were not associated with survival. Conclusions: Bipolar steroid-eluting epicardial leads have an acceptable survival compared with unipolar non-steroid-eluting, without a significant difference regarding patients age. Therefore, they could be an excellent alternative for endocardial ones.

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“…We illustrated that bipolar steroid‐eluting epicardial leads remained functional significantly better than unipolar nonsteroid‐eluting ones. Some studies investigated bipolar and unipolar leads pacing characteristics in the short‐term, implying that the bipolar group had fewer sensing and pacing failure 10,11 . The probable underlying mechanism has been declared to be related to the coaxial design of Medtronic bipolar leads, which results in a lower chance of stray signal pick‐up and better conduction performance 10 .…”

Section: Discussionmentioning

confidence: 99%

A survival analysis of bipolar steroid‐eluting and unipolar nonsteroid‐eluting epicardial leads

Fazelifar

Taghavyan

Moeeni

et al. 2022

Cardiovasc electrophysiol

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Introduction Epicardial pacemakers are known as an alternative for endocardial pacemakers in some cases such as heart block, and complex congenital heart diseases. Considering recent advances and improvement of epicardial lead subtypes, it is essential to investigate the long‐term function of them. In this study, we aimed to assess the sensing and pacing characteristics, and survival of bipolar steroid‐eluting and unipolar nonsteroid‐eluting epicardial pacemakers. Methods We conducted an entirely concentrated search on the documents of all patients who had undergone epicardial lead implantation in the Shaheed Rajaie Cardiovascular, Medical & Research Center during 2015–2018. Implant, and follow‐up data were extracted. Kaplan–Meier analysis and Weibull regression hazards model were applied for the survival analysis. Results Eighty‐nine leads were implanted for 77 patients. Of the total leads, 52.81%, 53.93%, and 47.19% were implanted in children (under 18‐year‐old), females, and patients with congenital heart diseases, respectively. Bipolar steroid‐eluting leads comprised 33.71% of 89 leads. The pacing threshold of unipolar nonsteroid‐eluting leads that were implanted on the left ventricle and right atrium increased significantly during the follow‐up to greater records than bipolar steroid‐eluting leads. Survival analysis also revealed that bipolar steroid‐eluting leads are significantly better in 48‐month survival (Weibull hazard ratio [HR]: 0.13 (95% confidence interval [CI]: 0.02–0.99), p = .049). Age, ventricular location of the lead, and acute pacing characteristics were not associated with survival. Conclusions Bipolar steroid‐eluting epicardial leads have an acceptable survival compared with unipolar nonsteroid‐eluting, without a significant difference regarding patients age. Therefore, they could be an excellent alternative for endocardial ones.

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Bipolar Versus Unipolar Temporary Epicardial Ventricular Pacing Leads Use in Congenital Heart Disease: A Prospective Randomized Controlled Study

Cited by 4 publications

References 13 publications

Transcoronary mapping and chemical ablation of ventricular tachycardia in no-entry left ventricle

Transcoronary mapping and chemical ablation of ventricular tachycardia in no-entry left ventricle

A survival analysis of bipolar steroid-eluting and unipolar non-steroid-eluting epicardial leads

A survival analysis of bipolar steroid‐eluting and unipolar nonsteroid‐eluting epicardial leads

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