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- Title
Do Steroid-Eluting Electrodes Really Have Better Performance Than Other State-of-the-Art Designs?
- Authors
Santini, Massimo; de Seta, Francesco
- Abstract
A multicenter study evaluated the performance of atrial and ventricular unipolar leads with porous steroid-eluting and platinized grooved electrodes. A total of 563 leads were implanted in 451 patients. These included 311 ventricular and 97 atrial steroid-eluting electrodes; and 112 ventricular and 43 atrial leads with platinized electrodes. Mean follow-up was ≥ 1 year. At implant there were no significant differences in threshold parameters in either chamber. Chronically, however, the steroide-eluting lead consistently had significantly lower pacing thresholds in both chambers. For example, after 360 days implant, steroid-eluting electrodes had 0.23 ± 0.10 msec ventricular thresholds at 0.8 V compared to 0.45 ± 0.3 msec in the platinized group (P < 0.0001). In the atrium, the steroid-eluting lead's 6-month thresholds at 0.8 V were 0.15 ± 0.06 msec compared to 0.9 ± 0.8 msec for the platinized electrode (P < 0.01). The chronic ventricular QRS amplitudes were significantly greater for the steroid-eluting electrode (P < 0.0005). There were no significant differences in atrial sensing and no incidence of atrial undersensing in the study. The low and consistent thresholds of the steroid-eluting electrodes would have permitted pacing in the ventricle at ≤ 2.5 V without compromising safety factor in 99.4% of the patients. The other 0.6% required 5 V temporarily. In the atrium, 100% of the patients could have been paced safely at reduced output. In spite of this, 63% of the implanters lacked the confidence to use reduced outputs.
- Subjects
ELECTRODES; CARDIAC pacing; ELECTRIC stimulation; CARDIAC pacemakers; IMPLANTED cardiovascular instruments; MEDICAL equipment
- Publication
Pacing & Clinical Electrophysiology, 1993, Vol 16, Issue 4, p722
- ISSN
0147-8389
- Publication type
Article