UNSATISFYING RESULTS IN LONG-TERM ATRIAL-PACING WITH A BIPOLAR ACTIVEFIXATION ATRIAL LEAD

A high dislodgment rate during long-term atrial pacing using the unipo lar sickle-shaped active fixation lead was recently reported; therefor e, the long-term results of atrial pacing in 118 consecutive patients with the bipolar sickle-shaped active fixation lead (Biotronik FH60-BP ) were evaluated. Between January 1989 and September 1993, 87 leads (7 4%) were inserted for dual chamber pacing and 31 leads (26%) for atria l pacing only. At the time of implantation, the bipolar atrial electro gram had a mean voltage of 4.4 +/- 1.6 mV, whereas the acute atrial th reshold was 0.72 +/- 0.38 V and 1.46 +/- 0.67 mA at 0.5-msec pulse dur ation and mean resistance 506 +/- 79 Omega. Early lead dislodgment (< 1 month after implantation) occurred in 9 patients (7.6%). During a me an follow-up of 21.8 months (median 20.9 months), late dislodgment (> 1 month after implantation) occurred in 6 patients (5.1%) after a mean interval of 7.9 months (range 3-14 months). Due to the unacceptably h igh late dislodgment rate, which to date remains unexplained, new impl ants of this lead are not recommended.