[Lithium-powered cardiac pacemakers. A survey of 3 years' clinical experience (author's transl)]

In addition to the lithium-iodine cell which has been in clinical use since 1972, the following lithium-based power sources for cardiac pacemakers are available: The lithium-silver chromate cell (SAFT), the lithium-thionylchloride-battery (G.T.E.), the lithium-cupric sulfide cell (DuPont) and the lithium-lead iodide cell (Mallory). These batteries differ not only in their energy providing chemical reaction and their components (liquid electrolyte or not), but also in their capacity and discharge characteristics. Out of 244 lithium-powered pacemakers implanted during the past 3 years, 5 pulse generators had to be removed due to electronic circuit failure, whereas battery failure has not been observed up till now. Sensing problems were registered in 8 cases probably due to the specific properties of the entrance filter and entrance resistance of the pacer. In some cases, however, they were caused by poor electrode position. One pacemaker model, powered with the WGL702 cell, frequently gave rise to skin necrosis, Newer models have more favourable dimensions and lower specific weight. The capacity of their batteries is sufficient for middle to long-term stimulation when using current saving electrodes. Because of the well-known advantages of the lithium-cells in comparison to conventional Mallory batteries, together with the favorable clinical results, only lithium-powered pacemakers have been implanted in our hospital since 1977.