Long-Term Experience with a Preshaped Left Ventricular Pacing Lead

OLLITRAULT, J., et al.: Long-Term Experience with a Preshaped Left Ventricular Pacing Lead.This study describes a long-term experience with a new LV pacing lead. The study population consisted of 62 patients (85% men,71 ± 10years old) with advanced dilated cardiomyopathy, in NYHA Class III or IV despite optimal drug therapy, and a QRS duration >150 ms. Patients in sinus rhythm were implanted with a triple chamber pacemaker to maintain atrioventricular synchrony. A dual chamber pacemaker was implanted in patients in atrial fibrillation for biventricular pacing only. A clinical evaluation and interrogation of the resynchronization pacemaker were performed at implant, at 1 week (W1), one (M1), four (M4), and seven (M7) months after implantation. A longer follow-up (2 years) is available for patients implanted at the authors institution. LV measurements were pacing threshold at 0.5-ms pulse duration and pacing impedance. R wave amplitude (mV) was measured at the time of implantation only. The system was successfully implanted in 86% of patients with the latest design of the lead. Mean R wave amplitude at implant was15 ± 7 mVand mean pacing impedance was1054 ± 254 Ω. Between implant(n = 38)and M7(n = 15), pacing threshold rose from0.73 ± 0.54to1.57 ± 0.60 V (P < 0.001). In conclusion, the situs lead was successfully implanted in a high percentage of patients. In addition, low pacing threshold and high impedance measured during follow-up are consistent with a low pacing current drain, ensuring a durable pulse generator longevity. (PACE 2003; 26[Pt. II]:185–188)