Preliminary clinical results of a biphasic waveform and an RV lead system

Ali A. Mehdirad, Charles J. Love, Marshall S. Stanton, S. Adam Strickberger, James L. Duncan, Mark W. Kroll

Research output: Contribution to journalArticlepeer-review

Abstract

Biphasic defibrillation waveforms have provided a reduction in defibrillation thresholds in transvenous ICD systems. Although a variety of biphasic waveforms have been tested, the optimal pulse durations and tilts have yet to be identified. A multicenter clinical study was conducted to evaluate the performance of a new ICD biphasic waveform and new RV active fixation steroid elating lead system. Fifty-three patients were entered into the study. Mean age was 63 years with a mean ejection fraction of 36.8%. Primary indication for implantation was monomorphic ventricular tachycardia alone (54.7%). Forty-eight patients(90.6%) were implanted with an RV shocking lead and active can alone as the anodal contact. The ICD can was the cathode. In four cases (7.5%), an additional SVC or CS lead was used due to a high DFT with the RV lead alone. In an additional case, a chronic SVC lead was used although the RV-Can DFT was acceptable. DFT for all cases at implant was 9.8 ± 3.7 J. Repeat testing at 3 months for a subset of patients showed a reduction in DFT (7.4 ± 3.0 J), P value = 0.03. Sensing and pacing characteristics of the RV lead system remained excellent during the study period (acute 0.047 ± 0.005 ms at 5.4 V and 9.9 ± 6.2 mV R wave; chronic 0.067 ± 0.11 ms at 5.4 V and 9.3 ± 5.4 mV R wave). It is concluded that this lead system provides good acute and chronic sensing and pacing characteristics with good DFT values in combination with this waveform.

Original languageEnglish (US)
Pages (from-to)594-599
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume22
Issue number4 I
DOIs
StatePublished - 1999

Keywords

  • Defibrillation threshold
  • Implantable defibrillator
  • Steroid eluting lead
  • Transvenous lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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