Active-fixation, steroid-eluting ventricular leads: the medium-term results in children
1Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi, Pediyatrik Kardiyoloji ve Anabilim Dalı, Altunizade, İstanbul-Türkiye
2Department of Pediatric Cardiology Faculty of Medicine, Hacettepe University, Ankara, Turkey
3Department of Pediatrics Cardiology, Faculty of Medicine, Hacettepe University, Sıhhiye, Ankara
4Pediatric Cardiology Unit, Hacettepe University, İhsan Doğramacı Children’s Hospital, Sıhhiye, Ankara, Turkey
Anatol J Cardiol 2005; 5(4): 278-282 PubMed ID: 16330392
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Abstract

Objective: Low threshold characteristics and mechanical stability are important features of an ideal pacing lead, especially for children. We report our experience and medium-term results with a steroid-eluting, active-fixation ventricular lead in children. Methods: Telectronics Accufix II DEC model 033-212 ventricular leads were implanted in 21 patients. Eighteen patients (11 male / 7 female; 10.6 ± 4.0 years), who were followed for a mean period of 6.47 ± 1.13 years were included in the study. Results: Pacemaker mode was DDDR in three patients, and VVIR in the remaining 15 patients. Mean threshold value was 0.5 volts at implant, which increased to 0.7 volts in the first month (p>0.05). It remained stable (0.62-0.78 V) until 5.5 years (p>0.05), increased significantly at 5.5 years (0.99 ± 0.63 V at 5.5 years, p<0.05) and remained significantly high after this time (p<0.05). Pacing lead impedance did not differ significantly throughout the study (p>0.05). Thirteen pulse generators reached end-of-life at ≥ 4 years. In all the patients whose generators were replaced (11 patients), the leads were kept in place. Conclusion: Steroid-eluting active-fixation ventricular leads have long service lives and low chronic stimulation threshold values, allowing lower outputs. These features may have advantages in pacing therapy of children