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Permanent Leads (permanent + lead)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Predicting implantation with a neuromodulator using two different test stimulation techniques: A prospective randomized study in urge incontinent women,

NEUROUROLOGY AND URODYNAMICS, Issue 1 2007
Kristy M. Borawski MD
Abstract Aims The purpose of this study was to determine whether a percutaneous needle electrode (PNE) technique or a surgical first stage lead placement (FSLP) better predicted whether a patient would progress to implantation of a pulse generator (IPG) in older urge incontinent women. Methods Thirty subjects ,55 years with refractory urge incontinence who had been selected to undergo a test stimulation procedure were randomized to either PNE or FSLP. Thirteen underwent PNE placement and seventeen underwent FSLP placement. If during the test stimulation period subjects had greater than 50% improvement in their incontinence parameters they qualified for permanent lead and/or IPG implantation of the Interstim® device. Results Twenty-one subjects (70%) responded to the test stimulation and underwent implantation, 15/17 (88%) in the FSLP group and 6/13 (46%) in the PNE group. Subjects who were randomized to the FSLP group were significantly more likely to proceed to implantation of the IPG (P,=,0.02) than those in the PNE group. There was no significant difference in demographics, pre-test stimulation incontinence parameters or post-stimulation visual analog pain scores between the randomized groups or between test stimulation responders and non-responders. When comparing FSLP and PNE responders, there was no significant difference in the percent improvement in 24-hr pad weight, daily pad usage, or daily incontinence. Conclusion FSLP better predicted progression to implantation of the IPG than a test stimulation with a PNE in an older urge incontinent cohort. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source]

Spinal cord stimulation with percutaneous leads after loss of coverage with implanted surgical lead

NEUROMODULATION, Issue 2 2010
Alexander E. Yakovlev MD
Objective:, This case report presents an application of percutaneous spinal cord stimulation to a patient with complex regional pain syndrome type 1 involving the bilateral lower extremities with loss of coverage with surgical lead. Measurements:, The patient underwent an uneventful spinal cord stimulator trial with percutaneous placement of two temporal eight-electrode epidural leads (Medtronic Inc, Minneapolis, MN, USA) to level T11. Results:, Upon experiencing excellent pain relief over the next three days, the patient was implanted with permanent leads and rechargeable generator four weeks later and reported sustained pain relief. Conclusion:, Percutaneous spinal cord stimulation offers an alternative treatment option for the patient with loss of coverage with surgical lead. [source]

Peripheral Nerve Stimulation in Treatment of Intractable Postherpetic Neuralgia

NEUROMODULATION, Issue 4 2007
Alexander E. Yakovlev MD
ABSTRACT Objective., This case report presents an application of peripheral nerve stimulation to a patient with intractable postherpetic neuralgia that conventional treatment failed to ameliorate. Methods., The patient underwent an uneventful peripheral nerve stimulator trial with placement of two temporal eight-electrode percutaneous leads (Octrode leads, Advanced Neuromodulation Systems, Plano, TX, USA) into the right subscapular and right paraspinal area of the upper thoracic region. Results., Upon experiencing excellent pain relief over the next two weeks, the patient underwent implantation of permanent leads two weeks later and reported sustained pain relief. Conclusion. Peripheral nerve stimulation offers an alternative treatment option for intractable pain associated with postherpetic neuralgia, especially for elderly patients where treatment options are limited due to existing comorbidities. Further studies are warranted. [source]

Development of an Echocardiographic Method for Choosing the Best Fitting Single-Pass VDD Lead

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2002
WEI-HSIAN YIN
YIN, W.-H., et al.: Development of an Echocardiographic Method for Choosing the Best Fitting Single-Pass VDD Lead. To achieve stable single-lead VDD pacing, a selection of the electrode with the optimal distance between the lead tip and the floating atrial dipole (AV distance [AVD]) is important. The authors hypothesized that the size of the right heart chambers may affect atrial sensing, and that measurement of their internal dimension at end-diastole (RHIDd) in the apical four chamber view by transthoracic echocardiography may aid in choosing the proper AVD. Twenty-six consecutive cases that had undergone VDD pacer implantation using the conventional chest X ray were examined retrospectively by the echocardiographic method. The chest x-ray method properly selected a lead with optimal atrial sensing, defined as minimum P wave amplitude , 1.0 mV, for only 20 (77%) of 26 patients. By comparing these results with their respective RHIDd, a cut-off point of 13 cm was obtained that indicated a criterion for choosing the proper AVD. The indication was that if the RHIDd was , 13 cm, a lead with an AVD of 15.5/16 cm should have been used; if the RHIDd was < 13 cm, a lead with an AVD of 13/13.5 cm should have been chosen. Using the echocardiographic method, all six patients who had suboptimal atrial sensing could be identified and classified as having missized (four undersized; two oversized) permanent leads. In conclusion, the described method provides a promising preoperative assessment of the best fitting electrode length in single lead VDD pacing. A prospective study is ongoing to verify its applicability. [source]

Diagnosis and Management of Inadvertently Placed Pacing and ICD Leads in the Left Ventricle: A Multicenter Experience and Review of the Literature

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2000
BERRY M. VAN GELDER
Three patients from different centers with pacemaker or ICD leads endocardially implanted in the left ventricle are described. All leads, two ventricular pacing leads and one ICD lead, were inserted through a patent foramen ovale or an atrial septum defect. The diagnosis was made 9 months. 14 months, and 16 years, respectively, after implantation. All patients had right bundle branch block configuration during ventricular pacing. Chest X ray was suggestive of a left-sided positioned lead except in the ICD patient. Diagnosis was confirmed with echocardiography in all patients. One patient with a ventricular pacing lead presented with a transient ischcmic attack at 1-month postimplantation. During surgical repair of the atrial septum defect 14 months later, the lead was extracted and thrombus was attached to the lead despite therapy with aspirin. The other patients were asymptomatic without anticoagulation (9 months and 16 years after implant). No thrombus was present on the ICD lead at the time of the cardiac transplantation in one patient. We reviewed 27 patients with permanent leads described in the literature. Ten patients experienced thromboembolic complications, including three of ten patients on antiplatelet therapy. The lead was removed in six patients, anticoagulation with warfarin was effective for secondary prevention in the four remaining patients. In the asymptomatic patients, the lead was removed in five patients. In the remaining patients, 1 patient was on warfarin, 2 were on antiplatelet therapy, and in 3 patients the medication was unknown. After malposition was diagnosed, three additional patients were treated with warfarin. In conclusion, if timely removal of a malpositioned lead in the left ventricle is not preformed, lifelong anticoagulation with warfarin can be recommended as the first choice therapy and lead extraction reserved in case of failure or during concomitant surgery. [source]