Latest generation of unipolar and bipolar steroid eluting leads Long-term comparison of electrical performance in atrium and ventricles

Abstract

One hundred and seventy-three patients, mean age 74 years permanently paced with 123 atrial (53 unipolar, 70 bipolar) and 143 ventricular (73 unipolar, 70 bipolar) pacing leads were included in this study. The pacing leads were recent generation low surface area steroid eluting leads from one manufacturer: leads with silicone and polyurethane insulation were studied, and they were combined with generations of one pacemaker family from the same manufacturer permitting identical measurements to be made over a follow-up of 2 years. Pacing threshold was measured using pulse duration at a fixed voltage of 1.5 V: peak to peak P and R wave amplitude and pacing impedance at 2.5 V and 0.5 ms were all measured using the manufacturer's standard programmer. Although many significant differences, in the parameters measures, existed between atrium and ventricle and unipolar and bipolar configurations, none was felt to be of clinical significance. These data permit the physician to choose the lead type with regard to sensing performance and long-term lead integrity.

Safety, Handling and Electrical Performances of Bradycardia Leads in Acute Conditions: Results from the FINE Registry

“…Electrical performances were within ranges retrieved in the literature for the atrium: PCT was comparable to values observed by Kistler et al [9], P-wave amplitude were close to those reported by Rickard [6] and Cornacchia [10], and impedance values compared to those found by Kistler [9] and Lotze et al [11]. In the ventricle, PCT values compared with those reported by Rickard [6] and Lotze et al [11]; sensing amplitude were aligned with Nagatomo et al [12] and Schuchert et al [13].…”

Understanding Pacing-Induced Cardiomyopathy: a mini review

“…Whereas, in the bipolar lead, there is a separate lead between sensing lead and pacing lead. Bipolar lead more superior in eliminating oversense noncardiac signal (Cornacchia et al, 2000). In the Unipolar lead system, the metal part of the pacemaker's generator serves as an anode (positive pole) and lead as a cathode (negative pole).…”

“…In few cases, the unipolar lead's sensing and capture thresholds might be superior to bipolar lead (Cornacchia et al, 2000). To overcome unipolar lead's problem in over-sense pectoral myopotential, protective coating on the device might contribute in this case.…”