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Defibrillation Lead (defibrillation + lead)
Selected AbstractsImplantation of a Dual Chamber Pacing and Sensing Single Pass Defibrillation LeadPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 4 2001RAINER GRADAUS GRADAUS, R., et al.: Implantation of a Dual Chamber Pacing and Sensing Single Pass Defibrillation Lead. Dual-chamber ICDs are increasingly used to avoid inappropriate shocks due to supraventricular tachycardias. Additionally, many ICD patients will probably benefit from dual chamber pacing. The purpose of this pilot study was to evaluate the intraoperative performance and short-term follow-up of an innovative single pass right ventricular defibrillation lead capable of bipolar sensing and pacing in the right atrium and ventricle. Implantation of this single pass right ventricular defibrillation lead was successful in all 13 patients (age 63 ± 8 years; LVEF 0.44 ± 0.16; New York Heart Association [NYHA] 2.4 ± 0.4, previous open heart surgery in all patients). The operation time was 79 ± 29 minutes, the fluoroscopy time 4.7 ± 3.1 minutes. No perioperative complications occurred. The intraoperative atrial sensing was 1.7 ± 0.5 mV, the atrial pacing threshold product was 0.20 ± 0.14 V/ms (range 0.03,0.50 V/ms). The defibrillation threshold was 8.8 ± 2.7 J. At prehospital discharge and at 1-month and 3-month follow-up, atrial sensing was 1.9 ± 0.9, 2.1 ± 0.5, and 2.7 ± 0.6 mV, respectively, (P = NS, P < 0.05, P < 0.05 to implant, respectively), the mean atrial threshold product 0.79, 1.65, and 1.29 V/ms, respectively. In two patients, an intermittent exit block occurred in different body postures. All spontaneous and induced ventricular arrhythmias were detected and terminated appropriately. Thus, in a highly selected patient group, atrial and ventricular sensing and pacing with a single lead is possible under consideration of an atrial pacing dysfunction in 17% of patients. [source] Intraoperative Comparison of a Subthreshold Test Pulse with the Standard High-Energy Shock Approach for the Measurement of Defibrillation Lead ImpedanceJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2006ANDREAS SCHUCHERT M.D. There are two methods to measure shocking lead impedance: delivery of high-energy shocks that require patient sedation, and the painless measurement of impedance from subthreshold test pulses. The aim of this study was to compare the two methods. Methods: The study included 131 patients implanted with a standard DR (n = 71) or VR (n = 60) ICD connected to either single-coil (n = 39) or dual-coil (n = 92) defibrillation leads. The noninvasive high-energy impedance test was done using a 17 J shock after induction of ventricular tachyarrhythmias and compared to a 0.4 ,J test pulse used by the ICD for the subthreshold measurements. Results: Defibrillation lead impedance measurements were not significantly different between patients with the same shocking vector configuration. In patients with a single-coil defibrillation lead the impedance was 62 ± 9 , with the high-energy shock and 62 ± 8 , with the subthreshold test pulses (P = 0.13). Patients with a dual-coil configuration recorded average impedances of 40 ± 5 , from both tests (P = 0.44). While there was no difference in values recorded within each lead configuration, there was a significant difference in impedance between the single-coil and the dual-coil patient groups (P = 0.001). Conclusions: There was no significant difference between shocking lead impedances measured with the high-energy shock or the subthreshold test pulses. This offers the possibility of noninvasive, low-energy serial measurements of shocking lead impedance at follow-up visits and removing the need for sedation. [source] | ||||||||||