Key result
The 3-turn screw-in epicardial electrode was associated with a lower rate of critical pacing threshold elevation resulting in exit block compared to the 2-turn electrode at 48 months (12% vs 20%, p<0.05).
Why the study?
Does a 2-turn screw-in myocardial electrode increase the risk of critical pacing threshold elevation compared to a 3-turn electrode in patients requiring epicardial pacing?
Population
270 patients requiring epicardial electrodes due to technical difficulties with the transvenous approach
Comparison
2-turn screw-in myocardial electrode inserted in… vs 3-turn screw-in myocardial electrode inserted in…
Design
Cohort
Follow-up
up to 48 months (up to 96 months for 3-turn group)
Authors
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May favor 3-turn epicardial electrodes to lower exit block risk; leaves open randomized confirmation of lead selection.
Cohort (n=270)
Does a 2-turn screw-in myocardial electrode increase the risk of critical pacing threshold elevation compared to a 3-turn electrode in patients requiring epicardial pacing?
Absolute Event Rate: 12% vs 20%
p-value: p=<0.05
The 2-turn screw-in myocardial electrode is associated with a significantly higher and earlier incidence of critical pacing threshold elevation compared to the 3-turn electrode.
Korhonen et al. (1984) conducted a cohort in Patients requiring epicardial electrodes (n=270). 3-turn screw-in electrode (Medtronic 6917) vs. 2-turn screw-in lead (Medtronic 6917 A) was evaluated on Critical elevation of the pacing threshold resulting in exit block at up to 48 months (p=<0.05). The 3-turn screw-in epicardial electrode was associated with a lower rate of critical pacing threshold elevation resulting in exit block compared to the 2-turn electrode at 48 months (12% vs 20%, p<0.05).
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