The safety and efficacy of chronic ventricular pacing at 1.6 volts using a steroid eluting lead

Steroid eluting leads may allow for lower chronic pacing thresholds and therefore lower pacing outputs. Twenty-two patients (15 presenting with syncope) were implanted with VVI or VVIR pacemakers and transvenous steroid eluting leads and followed for a mean of 20.6 months while being paced at 1.6 V and 0.6 msec. Mean acute voltage pacing thresholds were 0.40 V at 0.5 msec and chronic pulse width thresholds were 0.21 msec at 0.8 V. Pacemaker function was documented with one to three 24-hour Holter monitors, attached during the 2-6 week postimplant period, bimonthly transtelephonic monitoring, and monthly pacemaker clinic visits. No patient developed recurrent symptoms and consistent capture was verified in all patients on every 24-hour Holter recording and transtelephonic monitor. Chronic ventricular pacing at an output of 1.6 V at 0.6 msec is safe and effective when using a steroid eluting lead and potentially has implications for pacemaker longevity.