What is the clinical evidence from this study?

Study design: Observational. Population: Pacemaker implantation (n=100). Intervention: Active-fixation pacing leads. Primary outcome: Pacing parameters (threshold, sensing, impedance) over a 2-year follow-up.

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March 1, 2006

Long‐Term Performance of Active‐Fixation Pacing Leads: A Prospective Study

Key Result

Active-fixation pacing leads were associated with stable long-term pacing parameters over 2 years, despite a significant increase in ventricular threshold from day 1 to month 1 (P<0.01).

Study Design

Type

Observational (n=100)

PICO

Population

100 patients undergoing consecutive new dual-chamber pacemaker implants with active-fixation leads, followed for 2 years.

Exposure / Comparator

Active-fixation pacing leads

Primary Outcome

Pacing parameters (threshold, sensing, impedance) over a 2-year follow-up

Abstract

BACKGROUND: Despite the increasingly widespread use of active-fixation leads, long-term clinical follow-up of pacing lead outcomes is lacking. The aim was to analyze pacing parameters over a 2-year follow-up. We performed a prospective observational study of consecutive new pacemaker implants using the 1488T St. Jude (100) and the Medtronic 5076 (100) active-fixation leads. Detailed analysis of pacing parameters was collected at implant, day 1, and 1, 3, 6, 12, 18, and 24 months. METHODS AND RESULTS: One hundred patients underwent implantation of 100 dual-chamber pacemakers. Initial pacing parameters in the ventricle were threshold 0.7 +/- 0.2 V, R wave 12.0 +/- 6.5 mV, and impedance 879 +/- 224 Omega. Threshold increased significantly from day 1 (0.7 +/- 0.2 V) to month 1 (0.9 +/- 0.6 V, P 2 V (mean 3.3 +/- 0.9 V) all between day 1 and month 3. For all patients, R wave remained stable, but impedance declined significantly from day 1 (879 +/- 184 Omega) to month 1 (677 +/- 122 Omega, P 2 V (2.2 V) between day 1 and month 1. No patients underwent lead repositioning. Sensing and impedance remained stable over the long term. Patient follow-up was completed in 94% (6 unrelated deaths). There was an 8% incidence of atrial fibrillation. CONCLUSION: Active-fixation leads are generally associated with stable long-term pacing parameters.

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Cite This Study

Kistler et al. (Wed,) conducted a observational in Pacemaker implantation (n=100). Active-fixation pacing leads was evaluated on Pacing parameters (threshold, sensing, impedance) over a 2-year follow-up. Active-fixation pacing leads were associated with stable long-term pacing parameters over 2 years, despite a significant increase in ventricular threshold from day 1 to month 1 (P<0.01).

synapsesocial.com/papers/6a1eb6b8db9b8de29fa422eb https://doi.org/https://doi.org/10.1111/j.1540-8159.2006.00327.x

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