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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 threshold energy change calculated by subtracting baseline values from the pacing threshold energy at three months follow up. An increase greater than '0' therefore represents an increase in pacing threshold energy (impaired threshold) after three months while values less than '0' describe a decreased energy (improved threshold). Data presented as whiskerblot. The box represents percentile 25 through 75 with each group median marked by inner lines and group ranges with minimal and maximum values between bars.
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Figure 4: Pacing threshold energy change calculated by subtracting baseline values from the pacing threshold energy at three months follow up. An increase greater than '0' therefore represents an increase in pacing threshold energy (impaired threshold) after three months while values less than '0' describe a decreased energy (improved threshold). Data presented as whiskerblot. The box represents percentile 25 through 75 with each group median marked by inner lines and group ranges with minimal and maximum values between bars.

Mentions: Changes in pacing threshold energy between implant and three months follow up are presented in Figure 4. There were no significant differences for neither qualitative nor quantitative comparisons of pacing threshold between COI groups at three months after lead implant.


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 threshold energy change calculated by subtracting baseline values from the pacing threshold energy at three months follow up. An increase greater than '0' therefore represents an increase in pacing threshold energy (impaired threshold) after three months while values less than '0' describe a decreased energy (improved threshold). Data presented as whiskerblot. The box represents percentile 25 through 75 with each group median marked by inner lines and group ranges with minimal and maximum values between bars.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Pacing threshold energy change calculated by subtracting baseline values from the pacing threshold energy at three months follow up. An increase greater than '0' therefore represents an increase in pacing threshold energy (impaired threshold) after three months while values less than '0' describe a decreased energy (improved threshold). Data presented as whiskerblot. The box represents percentile 25 through 75 with each group median marked by inner lines and group ranges with minimal and maximum values between bars.
Mentions: Changes in pacing threshold energy between implant and three months follow up are presented in Figure 4. There were no significant differences for neither qualitative nor quantitative comparisons of pacing threshold between COI groups at three months after lead implant.

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