Uncoated MV pacemakers and pocket stimulation
2001
Europace
To fulifil an "auto-diagnostic pacemaker' the system requires a control signal, which reflects the present physiologic state of the myocardium and can be monitored with reasonable technological effort. The introduction of fractal-coated leads improves the extra-cellular signal detection. The ventdcular evoked response (VER) is an intracardiac signal resulting from the heart's electrical reaction to every effective ventricular pacing pulse and is derived in a unipolar fashion between the lead
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... and the pacemaker housing. The VER is based upon the action potentials of the myocardial cells and reflects the eletrophysiologic state, as well as the course of excitation in the myocardium. With the development of fractally iridium coated electrodes chronically implantable leads are available. Like the Ag-AgCI the frectally coated electrodes is non-polarizable. Aim: To assess VER stability and its behavior during two-year-follow-up. Material and Methods: A 13-patient group (61% male), all with Chagas' disease, mean age 62 + 10 years, were followed during 27 :t 3 months. All patients received LOGOS pacemaker and the Y60BP fractal leads (BIOTRONIK). Three different evaluations were performed at 2 months, 1 and 2 years after implantation. VER amplitudes were gotten from the ventdcular IEGM at each examination. As a statistic method we used analysis of varianca with a significance level of 95%. Results: Patients initially classified in NYHA class II did not change to a worse position, but kept in class il or changed to class I 2 years after the implantation. The ejection fraction (EF) had no significant differences along the follow-up. There were no changes in usual therapy and only two patients had one episode of AF 1 year after the implantation. Evaluation 2 months 1 year 2 years VER amplitude 12.4 ± 2.8 mV 12.3 ± 2.9 mV 12.4 ± 3.2 mV Vsntricular threshold 0.8 + 0.4 V 0.9 ± 0.5 V 0.7 ± 0.5 V Conclusion: We surveyed an invariable fractal-coated lead behavior, particularly in sensing properties. This was verified by the VER amplitude measurements without significant differences over two years.
doi:10.1016/eupace/2.supplement_1.a76-c
fatcat:buvb3eorb5eehkzdv3fghz2uia