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Clinical experience with steroid-eluting unipolar electrodes
F A Pirzada1, L J Moschitto, D Diorio
1Department of Cardiology, Malden Hospital, Boston University School of Medicine, Massachusetts 02148.
Pacing and Clinical Electrophysiology : PACE
|November 1, 1988
Summary
New steroid-eluting pacemaker electrodes show very low chronic thresholds, improving pacing efficiency. These innovative leads deliver corticosteroids to the heart tissue, reducing energy requirements for effective pacing over time.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Search for pacemaker leads with low chronic thresholds to improve pacing efficiency.
- Medtronic developed a novel electrode design capable of delivering corticosteroids at the myocardial tissue interface.
Purpose of the Study:
- To evaluate the performance of steroid-eluting electrodes in patients requiring cardiac pacing.
- To assess early and chronic pacing thresholds with the new electrode technology.
Main Methods:
- Twenty-three patients (17 female, 6 male) were implanted with steroid-eluting electrodes (4003 or 5023).
- Pacing modes included VVIM (n=13) and DDD (n=10) with various pulse generators.
- Pacing thresholds, resistance, and R wave were measured at implantation and during follow-up (1-88 weeks).
Main Results:
- Implantation thresholds were low: 0.40 ± 0.02 V at 0.66 ± 0.05 mA (0.50 ms pulse width).
- Chronic thresholds remained low, with pulse width thresholds at 2.5 V being 0.10 ms (n=11) or ≤0.05 ms (n=12).
- No loss of pacing capture or sensing was observed during the follow-up period.
Conclusions:
- Steroid-eluting electrodes demonstrate very low pacing thresholds in both early and chronic phases.
- This electrode design shows promise for enhanced pacing efficiency and potentially reduced long-term energy requirements.