Key result
Unipolar ventricular leads are linked to a ~6% pacemaker malfunction rate versus none with bipolar.
Why the study?
There is little information on incidence and risk factors for unipolar pacemaker dysfunction using modern lead designs.
Does unipolar ventricular lead configuration increase the risk of pacemaker dysfunction compared to bipolar configuration in patients with chronically implanted pacemakers?
Cross-Sectional (n=682)
Does unipolar ventricular lead configuration increase the risk of pacemaker dysfunction compared to bipolar configuration in patients with chronically implanted pacemakers?
Absolute Event Rate: 5.9% vs 0%
Unipolar pacemaker configuration is associated with a 5.9% incidence of dysfunction, with higher risk in older patients, those with heart failure, and those on antiarrhythmic drugs, suggesting bipolar leads are preferable in these groups.
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Unipolar configuration was associated with malfunctions in older and HF patients; leaves open optimal lead selection pending prospective data.
Wiegand et al. (2001) conducted a cross-sectional in pacemaker recipients (n=682). Unipolar ventricular lead configuration vs. Bipolar ventricular lead configuration was evaluated on pacemaker dysfunction (chest wall stimulation or myopotential oversensing). Unipolar ventricular lead configuration resulted in pacemaker malfunctions in 5.9% of patients, whereas no malfunctions occurred during bipolar configuration.
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