The Medtronic 6400 temporary pacemaker lead demonstrates acceptable electrophysiological properties and safety for temporary pacing after open-heart surgery.
May support Medtronic 6400 lead use post-surgery in select cases; leaves open confirmation in larger prospective studies.
A new temporary pacemaker lead, Medtronic 6400, with a solid defined electrode surface area of 7.5 mm2, has been implanted in 50 patients after open-heart surgery. One electrode was inserted intramyocardially on the right ventricle, while another was placed extracardially and served as a reference lead. Forty-six of the patients were followed postoperatively with measurements of myocardial stimulation threshold and resistance. In 25 of the patients, electrograms were recorded on magnetic tape for further computer analysis of amplitudes, slew rates, and signal source impedance. During constant current pacing, myocardial stimulation threshold increased from a median of 0.4 mA one hour postoperatively to a maximum value of 2.3 mA. In two patients (4.3%) intermittent pacing failure was seen. Stimulation resistance fell from a median of 875 omega to a minimum of 487 omega, with a subsequent increase of 598 omega before electrode removal. Both mean electrogram amplitude (7.35 mV) and slew rate (0.82 V/s) had their minimum values on the sixth postoperative day. Intermittent sensing failure was observed in 2/25 patients (8%). Signal source impedance was of a magnitude not likely to contribute to sensing failure. No complications were seen from the use of this lead. The new electrode is an important improvement in temporary pacemaker lead design.
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BREIVIK et al. (1982) studied this question.
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