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Related Experiment Videos

Direct and telemetered lead impedance

U M Ben-Zur1, S B Platt, J N Gross

  • 1Department of Medicine, Montefiore Medical Center, Bronx, New York.

Pacing and Clinical Electrophysiology : PACE
|November 1, 1994
PubMed
Summary

Telemetered lead impedance measurements (LIM) show a good correlation with direct measurements but are not identical. While stable in the first month, telemetered LIM can increase over the first year, necessitating a baseline measurement for accurate follow-up.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Lead impedance measurements (LIM) are crucial for assessing pacemaker lead function.
  • Telemetered LIM offers a non-invasive method for monitoring lead integrity over time.
  • Understanding the correlation and stability of telemetered LIM compared to direct measurements is essential for clinical practice.

Purpose of the Study:

  • To correlate telemetered lead impedance measurements (LIM) with direct LIM.
  • To assess the stability of LIM over time using both direct and telemetered methods.
  • To establish the reliability of telemetered LIM for long-term pacemaker lead monitoring.

Main Methods:

  • Direct and telemetered LIM were measured in 91 patients across 101 leads during implantation and replacement.

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  • Direct LIM measurements were compared between initial implant and pulse generator replacement in 41 patients.
  • Telemetered LIM stability was assessed at immediate postoperative, 1-month, and 1-year follow-ups in 50 patients.

    • Main Results:

    • A good correlation was observed between direct and telemetered LIM for both atrial (r=0.58 acute, r=0.87 chronic) and ventricular leads (r=0.69 acute, r=0.68 chronic).
    • Mean direct LIM increased significantly in atrial leads (124 Ω, P < 0.001) but not ventricular leads (10 Ω, P = NS) between initial implant and replacement.
    • Telemetered LIM showed stability in the first month but tended to rise throughout the first year, particularly in atrial leads.

    Conclusions:

    • Telemetered LIM provides a valuable but imperfect correlation with direct LIM measurements.
    • Direct LIM at initial implantation is comparable to measurements at pulse generator replacement.
    • Establishing an immediate postoperative baseline for telemetered LIM is critical for accurate long-term monitoring due to potential impedance increases with lead maturation.