A 12-year experience of bipolar steroid-eluting epicardial pacing leads in children.

Details

Serval ID
serval:BIB_AC5725737BD4
Type
Article: article from journal or magazin.
Collection
Publications
Title
A 12-year experience of bipolar steroid-eluting epicardial pacing leads in children.
Journal
Annals of Thoracic Surgery
Author(s)
Tomaske M., Gerritse B., Kretzers L., Pretre R., Dodge-Khatami A., Rahn M., Bauersfeld U.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
85
Number
5
Pages
1704-1711
Language
english
Abstract
BACKGROUND: Cardiovascular abnormalities and small vascular size may preclude transvenous pacing and necessitate epicardial lead implantation. This study evaluates the performance of steroid-eluting, bipolar epicardial pacing leads.
METHODS: We prospectively enrolled 114 children with 239 atrial and ventricular bipolar epicardial leads (Medtronic CapSure 10366 or 4968, Minneapolis, MN), followed up to 12.2 years (median, 3.2). Lead data were obtained at implant and at semi-annual visits. Analysis was done for left or right atrial and ventricular leads.
RESULTS: Median atrial and ventricular pacing thresholds remained below 1.2 V at 0.5 ms. Thresholds did not differ between pacing sites: left atrial, 0.82 V at 0.5 ms; right atrial, 0.74 V at 0.5 ms (p = 0.85); and left ventricular, 0.96 V at 0.5 ms; right ventricular, 0.94 V at 0.5 ms (p = 0.65). Sensing demonstrated no difference for atrial leads, at left atrial, 3.4 mV; and right atrial, 2.9 mV (p = 0.12), but there was superiority of left over right ventricular leads (11.2 vs 7.7 mV, p = 0.002). During follow-up, the 239 atrial and ventricular leads experienced 19 (8%) lead failures. Lead survival at 2 and 5 years was 99% and 94% for atrial leads and 96% and 85% for ventricular leads, respectively.
CONCLUSIONS: Bipolar steroid-eluting epicardial leads demonstrate excellent sensing characteristics and persistent low median pacing thresholds below 1.2 V at 0.5 ms in children during up to 12 years follow-up. Considering growing and active patients with most having congenital heart disease, the lead survival of 85% to 94% at 5 years is favorable. Subanalysis shows superior sensing for left ventricular leads. Bipolar steroid-eluting leads provide an alternative approach for permanent pacing and may also be considered for left atrial and ventricular pacing, resynchronization, or defibrillator therapy.
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Web of science
Create date
16/12/2014 19:16
Last modification date
20/08/2019 15:16
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