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Reliability of different temporary myocardial pacing leads
S Wirtz1, H D Schulte, J Winter
1Department of Thoracic and Cardiovascular Surgery, Heinrich Heine University of Düsseldorf, FRG.
The Thoracic and Cardiovascular Surgeon
|June 1, 1989
Summary
This study compared temporary myocardial pacing leads for reliability after open-heart surgery. Bipolar pacing leads demonstrated superior performance, especially for atrial sensing, making them recommended for postoperative pacing.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Temporary myocardial pacing leads are crucial for managing postoperative arrhythmias after open-heart surgery.
- Assessing the reliability of different pacing electrodes is essential for patient care.
Purpose of the Study:
- To compare the reliability of five different temporary myocardial pacing electrodes.
- To evaluate pacing and sensing functions over a 10-day postoperative period.
Main Methods:
- A standardized implantation technique was used for 147 ventricular and 81 atrial electrodes in 149 patients.
- Stimulation threshold, P- and R-wave sensing, and impedance were measured daily using a pacing system analyzer.
- Statistical analysis of mean values and comparison of pacing/sensing failures were performed.
Main Results:
- Bipolar pacing leads (Osypka TME 64a/66a) showed higher reliability than unipolar wires (Ethicon HD 12S, Osypka TME 60/60a), particularly in atrial sensing.
- Medtronic 6400/6500 leads exhibited good reliability for ventricular pacing, suitable for VVI-mode pacing.
- Parameter trends and failure rates were analyzed to determine lead performance.
Conclusions:
- Specially developed bipolar temporary pacemaker electrodes are recommended for reliable atrial and ventricular pacing post-surgery.
- Bipolar leads offer improved reliability for temporary myocardial pacing up to 10 days postoperatively.
- Selection of appropriate pacing leads impacts the efficacy of managing postoperative arrhythmias.
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