Document Detail


Simulation of mechanical environment in active lead fixation: effect of fixation helix size.
MedLine Citation:
PMID:  21744926     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The risk of myocardial penetration due to active-fixation screw-in type pacing leads has been reported to increase as the helix electrodes become smaller. In order to understand the contributing factors for lead penetration, we conducted finite element analyses of acute myocardial micro-damage induced by a pacemaker lead screw-in helix electrode. We compared the propensity for myocardial micro-damage of seven lead designs including a baseline model, three modified designs with various helix wire cross-sectional diameters, and three modified designs with different helix diameters. The comparisons show that electrodes with a smaller helix wire diameter cause more severe micro-damage to the myocardium in the early stage. The damage severity, represented by the volume of failed elements, is roughly the same in the middle stage, whereas in the later stage the larger helix wire diameter generally causes more severe damage. The onset of myocardial damage is not significantly affected by the helix diameter. As the helix diameter increases, however, the extent of myocardial damage increases accordingly. The present findings identified several of the major risk factors for myocardial damage whose consideration for lead use and design might improve acute and chronic lead performance.
Authors:
Xuefeng Zhao; Jonathan F Wenk; Mike Burger; Yi Liu; Mithilesh K Das; William Combs; Liang Ge; Julius M Guccione; Ghassan S Kassab
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of biomechanical engineering     Volume:  133     ISSN:  1528-8951     ISO Abbreviation:  J Biomech Eng     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-07-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7909584     Medline TA:  J Biomech Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  061006     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202.
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