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Published on: December 11, 2017
Active-fixation, steroid-eluting ventricular leads: the medium-term results in children
Canan Ayabakan1, Alpay Celiker, Tevfik Karagöz
1Pediatric Cardiology Unit, Hacettepe University, Ihsan Doğramaci Children's Hospital, Sihhiye, Ankara, Turkey. cayabakan@yahoo.com
Objective:
Low threshold characteristics and mechanical stability are important features of an ideal pacing lead, especially for children. We report our experience and medium-term results with a steroid-eluting, active-fixation ventricular lead in children.
Methods:
Telectronics Accufix II DEC model 033-212 ventricular leads were implanted in 21 patients. Eighteen patients (11 male / 7 female; 10.6+/-4.0 years), who were followed for a mean period of 6.47 +/-1.13 years, were included in the study.
Results:
Pacemaker mode was DDDR in three patients, and VVIR in the remaining 15 patients. Mean threshold value was 0.5 volts at implant, which increased to 0.7 volts in the first month (p>0.05). It remained stable (0.62-0.78 V) until 5.5 years (p>0.05), increased significantly at 5.5 years (0.99+/-0.63 V at 5.5 years, p<0.05) and remained significantly high after this time (p<0.05). Pacing lead impedance did not differ significantly throughout the study (p>0.05). Thirteen pulse generators reached end-of-life at > or =4 years. In all the patients whose generators were replaced (11 patients), the leads were kept in place.
Conclusion:
Steroid-eluting active-fixation ventricular leads have long service lives and low chronic stimulation threshold values, allowing lower outputs. These features may have advantages in pacing therapy of children.
