December 1, 2007Pacing and Clinical Electrophysiology
Current of Injury Predicts Acute Performance of Catheter‐Delivered Active Fixation Pacing Leads
Key result
The final measure of current of injury at 80 ms during pacemaker lead implantation was significantly associated with acute lead stability (P=0.032).
Why the study?
Does continuous monitoring of current of injury during fixation predict acute lead stability and performance better than assessment after final rotation in patients undergoing pacemaker lead implantation?
Population
18 patients undergoing pacemaker lead implantation with a catheter delivered, fixed screw, 4-Fr PPML.
Comparison
Continuous monitoring of lead parameters during… vs Assessment of parameters after final rotation of…
Design
Cohort
Follow-up
Acute (during implantation)
Authors
Discussion
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Implication
Final COI assessment after rotation predicts acute stability; leaves open whether continuous monitoring adds value.
Study Design
Type
Observational (n=18)
Structured PICO
Does continuous monitoring of current of injury during fixation predict acute lead stability and performance better than assessment after final rotation in patients undergoing pacemaker lead implantation?
P
Population
18 patients (mean age 70 +/- 9 years, 9 males) undergoing pacemaker lead implantation with a catheter delivered, fixed screw, 4-Fr PPML (Medtronic 3830).
I
Intervention
Continuous monitoring of lead parameters (R-wave amplitude, slew rate, and current of injury) during each turn of the helix during fixation.
C
Comparator
Assessment of parameters after final rotation of the lead.
O
Outcome
Acute lead stability (fixation) and pacing threshold adequacy.surrogate
Main Result
p-value: p=0.032
Assessment of the magnitude of injury current after final lead rotation is sufficient to predict acute lead stability and threshold adequacy, with no added benefit from continuous monitoring during fixation.
Cite This Study
Redfearn et al. (2007) conducted an observational in Pacemaker lead implantation (n=18). Measurement of current of injury (COI) was evaluated on Acute lead stability (p=0.032). The final measure of current of injury at 80 ms during pacemaker lead implantation was significantly associated with acute lead stability (P=0.032).