Lead fixation in dogs achieved with RF energy

Area of Science:

• Cardiovascular Engineering
• Biomedical Devices
• Electrophysiology

Background:

• Lead dislodgement is a significant complication in cardiac electronic device implantation.
• Current lead fixation methods, such as tines and screws, have limitations.
• Novel fixation techniques are needed to improve lead stability and reduce complications.

Purpose of the Study:

• To evaluate the efficacy of radiofrequency (RF) energy for endocardial lead fixation.
• To compare the dislodgment force and pacing thresholds of RF-fixed leads with conventional leads.
• To assess the long-term stability of RF-fixed leads in the right ventricle (RV) and coronary sinus (CS).

Main Methods:

• RF energy was used to fixate leads in the RV and CS of dogs.
• Dislodgment force and pacing thresholds were measured before and after RF fixation.
• Lead stability was assessed over a 12-week period.
• Comparison groups included leads without RF fixation, tined leads, and screw leads.

Main Results:

• RF fixation significantly increased lead dislodgment force in both the CS and RV compared to non-fixed leads.
• RF-fixed leads demonstrated higher acute pacing thresholds in both the CS and RV.
• Over 12 weeks, 5 of 6 CS leads and 8 of 10 RV leads remained attached.
• Chronic RV pacing thresholds for RF-fixed leads were comparable to tined and screw leads.

Conclusions:

• RF energy provides a reliable method for attaching pacemaker leads to the endocardium.
• While acute pacing thresholds increase, RF fixation offers comparable long-term stability to conventional methods.
• RF energy represents a promising alternative for lead fixation in cardiac electronic devices.