An observational study of the effect of coronary artery disease severity on acute pacing threshold and lead impedance in patients with permanent pacemaker

Abstract

An observational study of the effect of coronary artery disease severity on acute pacing threshold and lead impedance in patients with permanent pacemaker Kalıcı pacemaker'lı olgularda koroner arter hastalığı ciddiyetinin akut uyarı eşiği ve lead empedansı üzerine etkisini araştıran gözlemsel bir çalışma Original Investigation Özgün Araşt›rma ABSTRACTObjective: This study investigated the effect of coronary artery disease (CAD) severity, distribution and left ventricular ejection fraction (LVEF) on acute ventricular pacing threshold and lead impedance at the time of pacemaker implantation. Methods: One hundred and thirty-two patients who received a ventricular pacemaker or internal cardioverter-defibrilator (ICD) lead in our institution between 2007-2010 were included in this observational study. Patients were divided into ICD and anti-bradycardic pacemaker (PM) groups. Groups were compared for ventricular stimulation threshold, lead impedance and LVEF. Later, groups were sub-grouped according to the severity and distribution of CAD and subgroups were compared in both groups for ventricular stimulation threshold, lead impedance. Quantitative data of groups were compared by means of independent samples t-test.Results: Ventricular pacing thresholds were found significantly higher ICD group compared with PM group (p<0.05). Impedance and LVEF values were significantly lower in ICD group (p<0.05). Impedance and ventricular pacing thresholds were comparable in subgroups of ICD and PM groups. Our study does not confirm any relationship between pacing parameters and severity-distribution of CAD and LVEF. Conclusion: Patients with ventricular ICD lead had higher pacing thresholds but lower pacing impedance values comparing with PM group. This study did not find any significant relationship between pacing parameters at implantation and LVEF, severity and distribution of CAD. (

Lead impedance, pacing threshold and percentage of ventricular pacing according to the lead age – a cross-sectional study upon patients during follow-up.

“…This relation however was only observed when the ventricular lead was placed in the right ventricle (RV) apex, not in the RV outflow tract. Another study performed on 130 patients with a pacemaker or implantable cardioverter-defibrillator (ICD) revealed no associations between pacing parameters (lead impedance and pacing threshold) and distribution of LVEF or coronary artery disease, although the mean lead impedance was lower and mean pacing threshold was higher in the ICD patients than in pacemaker patients [11] . Pacing parameters might also be modified by proliferative scarring within the myocardium -the study by Vurgun et al showed that patients with proliferative scars in the right ventricle had a significantly higher pacing threshold compared with the control group matched by sex, age and lead type [12] .…”