High impedance low energy pacing leads: Long-term results with a very small surface area steroid-eluting lead compared to three conventional electrodes

We evaluated the handling performance at implant, and the long-term atrial and ventricular electrical performance of a new generation using a very sma ll surface area (1.2 mm(2)) steroid-eluting electrode (Medtronic CapSure Z) . We compared the performance of CapSure Z to that of traditional passive f ixation leads, with and without steroid elution. The study was conducted du ring 2 years of follow-up. We studied 188 patients (105 males and 83 female s; mean age 71 +/- 7 years). All of the patients were implanted with a dual chamber pacemaker and the same type of lead in both chambers. Forty-one pa tients received CapSure Z leads, 25 patients received Target Tip leads (8-m m(2) surface area; no steroid elution), 63 patients received CapSure leads (8-mm(2) surface area; steroid elution), and 59 patients received CapSure S P leads (5.8-mm(2) surface area; steroid elution). The four groups rr ere h omogeneous in regards to sea, age, cardiac disease, and reason for implant. At follow-up, the CapSure Z lead showed sensing values comparable to the ot her leads, with lower pacing thresholds and higher pacing impedance in both chambers. We evaluated the mean current drained from the pacemaker by the different types of leads rr hen using safe, low energy output settings. We found that by using CapSure Z leads, the mean current rr as significantly l ower than that of the other types of leads (0.42 mu A for CapSure Z ventric ular lead rs 0.85 for CapSure SP, 1.42 for CapSure, and 1.54 for Target Tip ). Thus, the use of the CapSure Z lead, combined with low energy output pro gramming, Mill increase pacemaker longevity compared to the use of traditio nal leads and standard output programming.