Document Detail

Pacemaker leads: performance and progress.
MedLine Citation:
PMID:  10089864     Owner:  NLM     Status:  MEDLINE    
Pacing leads remain the "weaker link" of the permanent pacing system. Lead failure has been an issue since the beginning of implantable pacemaker therapy. Modern electronics have brought about considerable progress in pacing technology, but lead design has been slower to evolve and problems persist. IS-1 standardization must be considered a significant advance, but some issues regarding IS-1 standardization persist and have been the cause of some compatibility problems. With respect to lead insulation, silicone has proved to offer total reliability for > 30 years. In the search for better handling characteristics, polyurethane 80A was employed for bipolar leads, but it failed to demonstrate satisfactory insulating properties. New insulation materials, such as ethylene-fluoro-ethylene (ETFE), and coated wire technology look promising, having shown 99.32% survival at 5-year follow-up. Reliability is the main objective in lead design, but leads should provide low battery consumption as well. Low coil resistance, with high electrode impedance in steroid-eluting leads, is the standard at present. Low polarization is a desirable property for 2 main reasons: (1) in conjunction with low-threshold leads, it decreases battery consumption; and (2) it allows capture detection and, therefore, safer pacing at low battery consumption. Lead tip design as well as pacing pulse configuration can influence polarization.
W G de Voogt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  83     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-04-07     Completed Date:  1999-04-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  187D-191D     Citation Subset:  AIM; IM    
Saint Lucas Andreas Hospital Amsterdam, The Netherlands.
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MeSH Terms
Electrocardiography / instrumentation
Electrodes, Implanted*
Equipment Design
Equipment Failure Analysis
Pacemaker, Artificial*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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