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Low polarization pacing lead for detecting the ventricular-evoked response
1Department for Biomedical Engineering, Friedrich-Alexander University of Erlangen-Nuremberg, Germany.
Medical Progress Through Technology
|January 1, 1993
Summary
New fractal-coated pacemaker leads significantly reduce polarization artifacts, enabling reliable cardiac capture recognition. This breakthrough improves pacemaker performance and patient outcomes.
Area of Science:
- Biomedical Engineering
- Cardiovascular Technology
- Materials Science
Background:
- Electrode polarization limits capture recognition in pacemakers.
- Existing electronic measures against polarization artifacts are often unsuccessful.
- Novel electrode coatings are needed to improve pacemaker function.
Purpose of the Study:
- To develop and evaluate novel pacemaker lead coatings for reduced polarization artifacts.
- To assess the efficacy of titanium nitride (TiN) and iridium (Ir) fractal coatings.
- To enable reliable ventricular-evoked response detection for capture recognition.
Main Methods:
- Developed TiN and Ir coatings with fractal surface structures.
- Implanted 15 endocardial leads (10 TiN, 5 Ir) in the right ventricle apex.
- Measured polarization artifacts and evoked responses, applying a 20-50 ms autoshort.
Main Results:
- Fractal TiN and Ir coatings reduced polarization artifacts by 90% compared to conventional leads.
- Autoshort application rendered polarization artifacts negligible.
- Reliable detection of the ventricular-evoked response's repolarization phase was achieved.
Conclusions:
- Fractal-coated electrodes significantly mitigate polarization artifacts in pacemakers.
- This technology enables reliable capture recognition, crucial for rate-adaptive systems.
- TiN- and Ir-coated electrodes offer unique stimulation and detection performance due to low polarization losses.