Improved Epimyocardial Pacing: Initial Experience with a New Bipolar, Steroid‐Elnting, High Impedance Lead Design

PETER P. KARPAWICH, KENNETH B. STOKES, KEITH PROCTOR, RICK SCHALLHORN, RICHARD McVENES, MATHEW FACTKOR

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Epicardial pacing typically is associated with decreased pacing and sensing capabilities compared with the endocardial approach. Since endocardial pacing is neither appropriate nor possible in all instances, this study was conducted to evaluate a new concept in a chronic epimyocardial lead design in six 3‐month‐old growing dogs. The new bifurcated lead (Medtronic model 10401) is a low current drain, high impedance, steroid‐eluting, bipolar design. The implant is facilitated by a suture attached with an atraumatic needle. Twelve ventricular leads were implanted (2 per animal) and followed for 6 months with weekly analysis of pacing and sensing capabilities. Results at explant were compared with implant values. There were no significant differences between implant and explant in sensed R waves, or in the slew rate of the R wave in unipolar or bipolar modes. Lead impedances at explant remained high in both modes: bipolar, 1550 ± 223; unipolar, 1234 ± 262 Ω (P < 0.05). Chronic voltage (v) threshold at 0.5 msec showed no significant change from implant values during the study: unipolar, 0.4 ± 0.2 vs 0.7 ± 0.3; bipolar, 0.5 ± 0.4 vs 1 ± 0.5. Histologic evaluations of the electrode tissue interface demonstrated negligible fibrotic capsule formation. This study introduces a new, easily implanted, high impedance, low threshold, bipolar epimyocardial pacing lead design with excellent chronic pacing and sensing characteristics.

Original languageEnglish
Pages (from-to)2032-2037
Number of pages6
JournalPacing and Clinical Electrophysiology
Volume17
Issue number11
DOIs
StatePublished - Nov 1994

Keywords

  • bipolar electrode
  • epimyocardial pacing
  • high impedance
  • steroid‐elution

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