Key result
Modern active fixation leads show lower chronic polarization voltage than standard leads without reducing charge threshold.
Why the study?
Do modern active fixation leads with vitreous carbon or iridium oxide tips improve stimulation characteristics and polarization properties compared to a standard elgiloy lead?
Observational (n=30)
Do modern active fixation leads with vitreous carbon or iridium oxide tips improve stimulation characteristics and polarization properties compared to a standard elgiloy lead?
Vitreous carbon and iridium oxide atrial fixation leads exhibit lower chronic polarization effects compared to standard elgiloy leads, but do not significantly reduce charge thresholds.
Lower polarization may not improve pacing efficiency; leaves open whether modern tips affect long-term atrial lead performance.
The purpose of the study was to compare the stimulation characteristics of two modern active fixation leads (Ela 583F, vitreous carbon tip [ELA] and Intermedics 82-0008-1601, iridium oxide tip [IROX]) with a standard lead (Osypka KY 67 VC, carbon-covered elgiloy tip [OSY]). In three groups of ten patients each, minimum charge threshold delta Qmin and polarization properties were determined via charge telemetry of the pacemaker (Intermedics Cosmos II and Relay) 0, 2, 5, 10, 28, 90, and 180 days after implant (dai). The polarization parameters global capacitance Cg, global resistance Rg, polarization voltage U(p), and a time constant t* (t* = Cg.Rg) were obtained by nonlinear regression. U(p) was always significantly (sig) lower in ELA and IROX (0.04-0.10 V) compared to OSY (0.54-0.76 V). Rg was sig lower in ELA (330-437 omega) compared to OSY and IROX (414-588 omega) from 0 to 28 dai. From 2 to 10 dai, Cg was sig higher in ELA and IROX (3.8-4.2 microF) compared to OSY (3.3-3.4 microF). In the three groups, delta Qmin reached a comparable maximum (1-1.2 microC) at 5 dai. Therefore, vitreous carbon and iridium oxide atrial fixation leads exhibit low chronic polarization effects compared to a standard elgiloy lead, but do not show a sig reduction in charge threshold.
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Kindermann et al. (1992) conducted an observational in Pacemaker implantation (n=30). Modern active fixation leads (ELA and IROX) vs. Standard lead (OSY) was evaluated on Minimum charge threshold and polarization properties. Modern active fixation leads (ELA and IROX) exhibited significantly lower chronic polarization voltage (0.04-0.10 V vs 0.54-0.76 V) than a standard lead, but did not reduce charge threshold.
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