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Steroid eluting high impedance pacing leads decrease short and long-term current drain: results from a multicenter
K A Ellenbogen1, M A Wood, D M Gilligan
1Department of Medicine, Medical College of Virginia, Richmond 23298-0053, USA. Kellenbogen@pol.net
Pacing and Clinical Electrophysiology : PACE
|February 17, 1999
Summary
New high impedance pacemaker leads demonstrate lower lead current drain compared to standard leads. This finding suggests potential for increased pulse generator longevity without compromising pacing or sensing capabilities.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Medical Device Technology
Background:
- Pacemaker lead technology has evolved, with steroid-eluting and porous electrodes reducing pacing thresholds and exit block.
- High impedance leads are theorized to decrease lead current drain, potentially extending pacemaker longevity.
- Limited clinical data exists on the performance of high impedance leads in large patient cohorts.
Purpose of the Study:
- To compare the performance of standard steroid-eluting pacing leads with new high impedance steroid-eluting leads.
- To evaluate differences in pacing impedance, lead current drain, and sensing characteristics between lead types.
- To assess the impact of high impedance leads on potential pulse generator longevity.
Main Methods:
- A multicenter, controlled trial involving 609 patients implanted with either standard or high impedance steroid-eluting atrial and ventricular leads.
- Measurements included bipolar pacing thresholds, pacing impedance, and sensing thresholds at implantation and up to 12 months post-implantation.
- Lead current drain was calculated based on measured impedance and pacing output.
Main Results:
- High impedance leads exhibited significantly higher mean impedance (atrium: 992 Ω vs. 522 Ω; ventricle: 1080 Ω vs. 600 Ω) compared to standard leads at 12 months (P < 0.001).
- Mean lead current drain was lower with high impedance leads (atrium: 2.6 mA vs. 4.9 mA; ventricle: 2.4 mA vs. 4.3 mA) at 12 months (P < 0.001).
- Pacing and sensing thresholds were similar between lead types, with a slightly larger R wave noted for high impedance leads at implantation and 12 months.
Conclusions:
- High impedance pacemaker leads are associated with significantly lower lead current drain compared to standard leads over a 1-year period.
- No clinically significant differences in sensing performance were observed between high impedance and standard leads.
- The reduced current drain suggests that high impedance leads may contribute to increased pulse generator longevity.
