INITIAL EXPERIENCE WITH A CO-RADIAL BIPOLAR PACING LEAD

A new type of endocardial bipolar pacing lead has been designed to ove rcome the potential drawbacks of the conventional coaxial bipolar paci ng lead. We prospectively evaluated the new co-radial bipolar pacing l eads (Intermedics Thin-Line), which are thinner (5 Fr vs 6-8 Fr) than standard coaxial bipolar leads. X-ray visibility and lead handling wer e subjectively assessed (excellent, good, adequate, or poor) at implan t; lead impedance, sensitivity threshold, and pacing threshold were me asured at implant, then at 1, 3, 6, 12, and 18 months. The results wer e as follows: 103 patients (51 M; age 63.8 +/- 17.4 years) received 71 atrial (A) and 89 ventricular (V) leads. X-ray visibility was excelle nt in 59/103; good in 23/103; adequate in 11/103; and poor in 10/103. Overall handling was excellent in 56/71 A and 69/89 V; good in 11/71 A and 18/89 V; adequate in 3/71 A and 1/89 V; poor in 1/71 A and 1/89 V . There were two perioperative complications. At implant: impedance in A and V were 370.1 +/- 74.7 and 501.5 +/- 124.4 Omega, sensing thresh olds in A and V were 3.0 +/- 1.5 and 9.9 +/- 5.0 mV, pacing thresholds at 0.45 ms in A and V were 0.59 +/- 0.21 and 0.41 +/- 0.15 volt, resp ectively. At 1, 3, 6, 12, and 18 months of follow-up: no pacing lead r elated complications were reported; pacing lead characteristics remain ed outstanding and stable. This new lead appears to have significant c linical advantages over the conventional coaxial bipolar pacing lead. Long-term follow-up is required to confirm its reliability and chronic performance characteristics.