INITIAL EXPERIENCE WITH A NEW ENDOCARDIAL STEROID SCREW-IN LEAD

The use of endocardial screw-in electrodes in permanent pacemaker impl ants is becoming increasingly popular for multiple reasons. This study compares a new steroid eluting, titanium nitride coated, retractable screw-in permanent pacing lead to an identical non-steroid eluting, no n-coated lead. Using a 3:1 randomization for atrial and ventricular le ads favoring the study lead (Pacesetter 1388T) vs the control lead (Pa cesetter 1188T), patients were implanted in a standard fashion at 35 c enters. Evaluation of the leads was performed at implant using a pacin g system analyzer. They were then evaluated using the pacemaker teleme try immediately post implant and at 2 weeks, 1 month, 3 months and 6 m onths. The study included 521 leads in 303 patients over a 6 month per iod. For both atrial and ventricular leads, capture and sensing thresh olds were significantly better for the study lead. In addition, and in contrast to the control lead, little to no ''peaking'' of the capture threshold occurred. Lead impedance was significantly lower for the st udy leads than for the control. In conclusion, excellent electrical ch aracteristics were documented acutely and through the first 3 months o f follow-up with the steroid eluting lead. Data at the 6 month follow- up is not significant due to small sample size at this time.