Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead

A randomized, controlled study

George H. Crossley, Jeffrey A Brinker, Dwight Reynolds, William Spencer, W. Ben Johnson, Howard Hurd, Lisa Tonder, Matt Zmijewski

Research output: Contribution to journalArticle

Abstract

Background: Prior work suggests that the addition of a steroid-eluting reservoir to a passive-fixation permanent pacemaker lead improves the stimulation threshold; however, no large randomized study has addressed this issue. Over the last several years, there has been an increase in enthusiasm for the use of active-fixation permanent pacemaker leads for various reasons in spite of the generally accepted notion that active-fixation leads have higher stimulation thresholds. Methods and Results: This multicenter, randomized, controlled study examined the difference in performance between a standard active-fixation atrial lead (Medtronic model 4058) and a steroid- eluting lead (Medtronic model 4068). Stimulation thresholds were obtained in a four-point strength-duration fashion. Evaluations of sensing and impedance were performed as well. These evaluations were performed at implantation, at weeks 1 through 4, and at weeks 6, 12, 24, and 52. Stimulation thresholds were significantly better in the steroid lead than in the nonsteroid lead at each measurement point from 1 week to 12 months. The mean 1.6-V stimulation threshold at 12 months was 0.19±0.2 ms in the steroid lead and 0.41±0.30 ms in the control lead. No acute peaking was observed with the steroid lead, whereas significant peaking was observed with the control lead. There was no difference in long-term sensing or impedance. Conclusions: Inclusion of a steroid-eluting reservoir in an active-fixation permanent pacing lead improved stimulation thresholds in both the subacute and chronic periods and therefore should extend pulse-generator longevity.

Original languageEnglish (US)
Pages (from-to)2935-2939
Number of pages5
JournalCirculation
Volume92
Issue number10
StatePublished - Nov 15 1995

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Steroids
Electric Impedance
Lead

Keywords

  • electrical stimulation
  • pacemakers
  • trials

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Crossley, G. H., Brinker, J. A., Reynolds, D., Spencer, W., Johnson, W. B., Hurd, H., ... Zmijewski, M. (1995). Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead: A randomized, controlled study. Circulation, 92(10), 2935-2939.

Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead : A randomized, controlled study. / Crossley, George H.; Brinker, Jeffrey A; Reynolds, Dwight; Spencer, William; Johnson, W. Ben; Hurd, Howard; Tonder, Lisa; Zmijewski, Matt.

In: Circulation, Vol. 92, No. 10, 15.11.1995, p. 2935-2939.

Research output: Contribution to journalArticle

Crossley, GH, Brinker, JA, Reynolds, D, Spencer, W, Johnson, WB, Hurd, H, Tonder, L & Zmijewski, M 1995, 'Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead: A randomized, controlled study', Circulation, vol. 92, no. 10, pp. 2935-2939.
Crossley, George H. ; Brinker, Jeffrey A ; Reynolds, Dwight ; Spencer, William ; Johnson, W. Ben ; Hurd, Howard ; Tonder, Lisa ; Zmijewski, Matt. / Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead : A randomized, controlled study. In: Circulation. 1995 ; Vol. 92, No. 10. pp. 2935-2939.
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