Reliability of Different Temporary Myocardial Pacing Leads

Abstract

Temporary myocardial pacing leads are routinely used for diagnosis and treatment of postoperative arrhythmias following open-heart surgery. The intention of this study is to compare five different electrodes for reliability during the postoperative period. A standardised technique of implantation was used to place 147 ventricular and 81 atrial wire electrodes in 149 patients. During operation and then daily over the next ten days, the stimulation threshold, P- and R-wave sensing, and impedance were measured with a pacing system analyser to evaluate the reliability of the pacing and sensing function. Five measurements were taken at each time; the mean values were statistically analysed. The number of failures in pacing and sensing and the course of the tested parameters during the postoperative period were compared. As a result, bipolar pacing leads (Osypka TME 64a/66a) proved to be more reliable than unipolar wires (Ethicon HD 12S, Osypka TME 60/60a), particularly in atrial sensing. Also the Medtronic 6400/6500 showed good reliability for the ventricle, so that they can be recommended for VVI-mode pacing. In conclusion, for reliable function during the postoperative course up to 10 days a specially developed bipolar temporary pacemaker electrode can be recommended for both atrial and ventricular or sequential pacing.

Evaluation of Fractal‐Coated Temporary Pacing Leads in the Early Postoperative Course

“…Temporary epicardial pacing wires are routinely used for treatment and diagnosis of arrhythmias following open heart surgery procedures. Postoperative external cardiac pacing may be necessary in a number of patients for several days and therefore needs reliable temporary pacing wires 1–3,4 . These wires may not only be required for antibradycardia therapy, but also for diagnosis of supraventricular tachycardias as atrial fibrillation or may even be mandatory for overdrive pacing of atrial flutter.…”

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

“…There are two adult clinical trials that have compared bipolar temporary epicardial pacing leads with unipolar leads . These studies have been conducted on postoperative patients with coronary artery disease and have reported that bipolar temporary pacing leads maintain improved pacing in the ventricle and have better sensing capabilities in the ventricle.…”

“…was also similar to what we found in our study. The other study in adult noncongenital patients by Wirtz et al . compared bipolar pacing leads (Osypka TME 64a/66a, Osypka TME 64/66, Osypka Medical GmbH, Berlin, Germany) to unipolar leads (Ethicon HD 12S, Osypka TME 60/60a, Medtronic 6400/6500) in 149 patients for 10 PODs.…”

“…Several improvements have been made in the design and implantation of epicardial leads to enhance the sensing and pacing capabilities. Bipolar pacing leads have been designed for better pacing characteristics as the spacing of the anode and cathode are closer. The current must travel a much shorter distance between the electrode tips of the bipolar pacing leads, and thus the electrical potential required to pace the myocardium is less than with the unipolar pacing leads.…”

Post operative temporary epicardial pacing: When, how and why?

“…As bipolar electrodes require less energy for capture, they have a longer longevity when compared to a unipolar system. [1213] Temporary epicardial pacing leads have been used for periods of up to 3 months when patient size or other factors may preclude implantation of a permanent pacing system. [5] Steroid eluting endovascular pacing wires are available for use with permanent pacemakers and significantly reduce the inflammation around the myocardium where the wire is attached.…”