Long-Term Performance of Bipolar Epicardial Atrial Pacing Using an Active Fixation Bipolar Endocardial Lead.
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| Title: | Long-Term Performance of Bipolar Epicardial Atrial Pacing Using an Active Fixation Bipolar Endocardial Lead. |
|---|---|
| Authors: | Epstein, Michael R.1, Walsh, Edward P.1, Saul, J. Philip1, Triedman, John K.1, Mayer Jr., John E.2, Gamble, Walter J.1 |
| Source: | Pacing & Clinical Electrophysiology. May1998, Vol. 21 Issue 5, p1098-1104. 7p. |
| Subjects: | Cardiac pacing, Endocardium, Cardiac surgery, Implanted cardiovascular instruments, Cardiac pacemakers, Medical equipment |
| Abstract: | Bipolar epicardial leads are not yet widely available for atrial use. Since September 1986, we have used a bipolar active fixation endocardial lead (Cardiac Pacemakers model number's 4266, 4268, and 4269) as a bipolar epicardial atrial lead by attaching the corkscrew tip to the a trial surface and imbricating atrial tissue around the more proximal electrode. A total of 77 bipolar epicardial atrial leads have been implanted using this approach in 72 patients with congenital heart disease (ages 3 months to 38.7 years; mean 8.9 ± 8.8 years). Indications for atrial pacing included AV block (n - 46), sinus node dysfunction (n = 17), and antitachycardial pacing (n = 9). Indications for epicardial pacing included the presence of intracardiac right to left shunt (n = 33), concomitant cardiac surgery (n = 26), surgeon preference (n = 7), and lock of transvenous access to the atrial endocardium (n = 6). Follow-up (median 23 months; mean 281) ± 23.1 months; range 1-78 months) data beyond 2 month postimplantation were available far 44 leads. Atrial sensing was ≥ 2.0 mV for 26 leads (59%) with sensing possible at ≥ 0.75 mV for 42 leads (95%). Threshold data were available at 5 V for 37 leads and at 2.5 V for 36 leads with mean pulse width thresholds measuring 0.21 ± 0.33 ms and 0.34 ± 0.34 ms, respectively. Two leads failed (high capture thresholds at 5 days [n = 1], lead fracture at 42 months (n = 1): one of which was replaced. Four additional leads were replaced electively (marginal thresholds [n = 1], intermittent phrenic: nerve stimulation [n = 1], damaged during subsequent surgery [n = 1], clinically irrelevant insulation break (n = 1) concomitant with additional cardiac surgery. Until a commercially available lead is developed and released, improvisation with a bipolar active fixation endocardial lead as a bipolar epicardial atrial lead is a reasonable approach to providing bipolar atrial sensing and pacing in patients for whom endocardial pacing is contraindicated. [ABSTRACT FROM AUTHOR] |
| Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: egs DbLabel: Engineering Source An: 17433597 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Long-Term Performance of Bipolar Epicardial Atrial Pacing Using an Active Fixation Bipolar Endocardial Lead. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Epstein%2C+Michael+R%2E%22">Epstein, Michael R.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Walsh%2C+Edward+P%2E%22">Walsh, Edward P.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Saul%2C+J%2E+Philip%22">Saul, J. Philip</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Triedman%2C+John+K%2E%22">Triedman, John K.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Mayer+Jr%2E%2C+John+E%2E%22">Mayer Jr., John E.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Gamble%2C+Walter+J%2E%22">Gamble, Walter J.</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. May1998, Vol. 21 Issue 5, p1098-1104. 7p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Cardiac+pacing%22">Cardiac pacing</searchLink><br /><searchLink fieldCode="DE" term="%22Endocardium%22">Endocardium</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+surgery%22">Cardiac surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Implanted+cardiovascular+instruments%22">Implanted cardiovascular instruments</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+pacemakers%22">Cardiac pacemakers</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+equipment%22">Medical equipment</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Bipolar epicardial leads are not yet widely available for atrial use. Since September 1986, we have used a bipolar active fixation endocardial lead (Cardiac Pacemakers model number's 4266, 4268, and 4269) as a bipolar epicardial atrial lead by attaching the corkscrew tip to the a trial surface and imbricating atrial tissue around the more proximal electrode. A total of 77 bipolar epicardial atrial leads have been implanted using this approach in 72 patients with congenital heart disease (ages 3 months to 38.7 years; mean 8.9 ± 8.8 years). Indications for atrial pacing included AV block (n - 46), sinus node dysfunction (n = 17), and antitachycardial pacing (n = 9). Indications for epicardial pacing included the presence of intracardiac right to left shunt (n = 33), concomitant cardiac surgery (n = 26), surgeon preference (n = 7), and lock of transvenous access to the atrial endocardium (n = 6). Follow-up (median 23 months; mean 281) ± 23.1 months; range 1-78 months) data beyond 2 month postimplantation were available far 44 leads. Atrial sensing was ≥ 2.0 mV for 26 leads (59%) with sensing possible at ≥ 0.75 mV for 42 leads (95%). Threshold data were available at 5 V for 37 leads and at 2.5 V for 36 leads with mean pulse width thresholds measuring 0.21 ± 0.33 ms and 0.34 ± 0.34 ms, respectively. Two leads failed (high capture thresholds at 5 days [n = 1], lead fracture at 42 months (n = 1): one of which was replaced. Four additional leads were replaced electively (marginal thresholds [n = 1], intermittent phrenic: nerve stimulation [n = 1], damaged during subsequent surgery [n = 1], clinically irrelevant insulation break (n = 1) concomitant with additional cardiac surgery. Until a commercially available lead is developed and released, improvisation with a bipolar active fixation endocardial lead as a bipolar epicardial atrial lead is a reasonable approach to providing bipolar atrial sensing and pacing in patients for whom endocardial pacing is contraindicated. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1540-8159.1998.tb00156.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 1098 Subjects: – SubjectFull: Cardiac pacing Type: general – SubjectFull: Endocardium Type: general – SubjectFull: Cardiac surgery Type: general – SubjectFull: Implanted cardiovascular instruments Type: general – SubjectFull: Cardiac pacemakers Type: general – SubjectFull: Medical equipment Type: general Titles: – TitleFull: Long-Term Performance of Bipolar Epicardial Atrial Pacing Using an Active Fixation Bipolar Endocardial Lead. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Epstein, Michael R. – PersonEntity: Name: NameFull: Walsh, Edward P. – PersonEntity: Name: NameFull: Saul, J. Philip – PersonEntity: Name: NameFull: Triedman, John K. – PersonEntity: Name: NameFull: Mayer Jr., John E. – PersonEntity: Name: NameFull: Gamble, Walter J. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May1998 Type: published Y: 1998 Identifiers: – Type: issn-print Value: 01478389 Numbering: – Type: volume Value: 21 – Type: issue Value: 5 Titles: – TitleFull: Pacing & Clinical Electrophysiology Type: main |
| ResultId | 1 |
