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Morphology of current of injury does not predict long term active fixation ICD lead performance.

Oswald H, Husemann B, Gardiwal A, Lissel C, Pichlmaier MA, Luesebrink U, Koenig T, Klein G - Indian Pacing Electrophysiol J (2009)

Bottom Line: Unipolar signals were recorded immediately after active fixation ICD lead positioning, blinded to the implanting surgeon.Signals were assigned to prespecified COI types by two independent investigators.All could be assigned to a particular COI with 48 type 1, 43 type 2 and 14 type 3 signals.

View Article: PubMed Central - PubMed

Affiliation: Baroda Heart Institute and Research Centre, Vadodara, India.

ABSTRACT

Background: Currents of injury (COI) have been associated with improved lead performance during perioperative measurements in pacemaker and ICD implants. Their relevance on long term lead stability remains unclear.

Methods: Unipolar signals were recorded immediately after active fixation ICD lead positioning, blinded to the implanting surgeon. Signals were assigned to prespecified COI types by two independent investigators. Sensing, pacing as well as changes requiring surgical intervention were prospectively investigated for 3 months.

Results: 105 consecutive ICD lead implants were studied. All could be assigned to a particular COI with 48 type 1, 43 type 2 and 14 type 3 signals. Pacing impedance at implant was 703.8+/-151.6 Ohm with a significant COI independent drop within the first week. Sensing was 10.6mV+/- 3.7mV and pacing threshold at implant was 0.8+/-0.3mV at 0.5ms at implant. There was no significant difference between COI groups at implant and during a 3 months follow up regarding sensing, pacing nor surgical revisions.

Conclusions: Three distinct patterns of unipolar endocardial potentials were observed in active fixation ICD lead implant, but COI morphology did not predict lead performance after 3 months.

No MeSH data available.


Related in: MedlinePlus

Pacing impedance in Ohm during the three months follow up. Light grey diamonds (♦) represent type 1 potentials, black squares (■) represent the group of type 2 potentials and grey triangles (▲) represent the group of type 3 potentials. Data presented as mean ± SD.
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Figure 3: Pacing impedance in Ohm during the three months follow up. Light grey diamonds (♦) represent type 1 potentials, black squares (■) represent the group of type 2 potentials and grey triangles (▲) represent the group of type 3 potentials. Data presented as mean ± SD.

Mentions: Mean pacing impedance measured through ICD telemetry at the end of ICD lead implant was 703.8±151.6 Ohm with no inter-group difference. There was a significant (p<0.05) decrease in pacing impedance within the first week after implant for all COI groups with no significant difference depending on the type of potentials of injury as shown in Figure 3. Impedance remained unchanged during further follow up after the first week drop.


Morphology of current of injury does not predict long term active fixation ICD lead performance.

Oswald H, Husemann B, Gardiwal A, Lissel C, Pichlmaier MA, Luesebrink U, Koenig T, Klein G - Indian Pacing Electrophysiol J (2009)

Pacing impedance in Ohm during the three months follow up. Light grey diamonds (♦) represent type 1 potentials, black squares (■) represent the group of type 2 potentials and grey triangles (▲) represent the group of type 3 potentials. Data presented as mean ± SD.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2655069&req=5

Figure 3: Pacing impedance in Ohm during the three months follow up. Light grey diamonds (♦) represent type 1 potentials, black squares (■) represent the group of type 2 potentials and grey triangles (▲) represent the group of type 3 potentials. Data presented as mean ± SD.
Mentions: Mean pacing impedance measured through ICD telemetry at the end of ICD lead implant was 703.8±151.6 Ohm with no inter-group difference. There was a significant (p<0.05) decrease in pacing impedance within the first week after implant for all COI groups with no significant difference depending on the type of potentials of injury as shown in Figure 3. Impedance remained unchanged during further follow up after the first week drop.

Bottom Line: Unipolar signals were recorded immediately after active fixation ICD lead positioning, blinded to the implanting surgeon.Signals were assigned to prespecified COI types by two independent investigators.All could be assigned to a particular COI with 48 type 1, 43 type 2 and 14 type 3 signals.

View Article: PubMed Central - PubMed

Affiliation: Baroda Heart Institute and Research Centre, Vadodara, India.

ABSTRACT

Background: Currents of injury (COI) have been associated with improved lead performance during perioperative measurements in pacemaker and ICD implants. Their relevance on long term lead stability remains unclear.

Methods: Unipolar signals were recorded immediately after active fixation ICD lead positioning, blinded to the implanting surgeon. Signals were assigned to prespecified COI types by two independent investigators. Sensing, pacing as well as changes requiring surgical intervention were prospectively investigated for 3 months.

Results: 105 consecutive ICD lead implants were studied. All could be assigned to a particular COI with 48 type 1, 43 type 2 and 14 type 3 signals. Pacing impedance at implant was 703.8+/-151.6 Ohm with a significant COI independent drop within the first week. Sensing was 10.6mV+/- 3.7mV and pacing threshold at implant was 0.8+/-0.3mV at 0.5ms at implant. There was no significant difference between COI groups at implant and during a 3 months follow up regarding sensing, pacing nor surgical revisions.

Conclusions: Three distinct patterns of unipolar endocardial potentials were observed in active fixation ICD lead implant, but COI morphology did not predict lead performance after 3 months.

No MeSH data available.


Related in: MedlinePlus