Clinical use of a new transvenous atrial lead

Kleinert, M; Bock, Michael; Wilhemi, Fritz

doi:10.1016/0002-9149(77)90014-5

Cited by 40 publications

(6 citation statements)

References 12 publications

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“…The acute P wave amplitudes obtained in the present study are by and large comparable with those obtained by other investigators using the same (Smyth et al, 1976;Kleinert et al, 1977) or different transvenous atrial leads (Rosenkranz and Schaldach, 1971;Cappelen and Hall, 1974;Furman et al, 1977;Geddes et al, 1978). The relatively minor differences may be explained by the technique of measuring especially as regards frequency response of the recording equipment (Citron et al, 1978).…”

Section: Discussionsupporting

confidence: 90%

“…facilitate the anchoring of the lead within the right atrial appendage where the tines may entangle with the trabeculae. Promising clinical results with this lead have also been presented by Kleinert et al (1977) and Citron et al (1978).…”

Section: Discussionmentioning

confidence: 86%

“…It should, however, be remembered that repositioning was a simple procedure resulting in stable function and that there has been no displacement in the last 20 patients. In the previous reports on the lead the dislodgement rate varies between 0 and 6 per cent (Smyth et al, 1976;Kleinert et al, 1977;Citron et al, 1978). In the patient who died (case 12) it was obvious that only the tines closest to the electrode tip were entangled in the trabeculae of the right atrial appendage while the other tines re-mained outside.…”

Section: Discussionmentioning

confidence: 93%

“…The reason for the limited use of atrial pacing is probably the lack of an electrode which combines a simple technique of introduction with long-term reliability. Recently promising results have been reported by the use of a transvenous J-shaped atrial tined lead (Smyth et al, 1976;Kleinert et al, 1977). These reports deal with the technique of introduction and electrophysiological characteristics of the lead at the time of electrode insertion.…”

mentioning

confidence: 99%

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Clinical and electrophysiological characteristics of a transvenous atrial lead.

Kruse¹,

Rydén²,

Ydse³

1979

Heart

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SUMMARY Despite some reports on the use of the atrial transvenous endocardial lead, Medtronic 6991, there is still very little information on the electrophysiological properties of the lead. A lead extension wire was connected to the atrial lead, passed subcutaneously, and brought through the abdominal skin. P wave amplitude, threshold of stimulation, and electrode resistance were repeatedly determined through the atrial lead during four weeks after the electrode insertion in 17 patients. Mean P wave amplitude at insertion was 3-7 ± 1 0 (mean ± SD) mV. It decreased significantly to a lowest mean level of 2-3 ±09 mV after one week. From that time there were only small variations. In the supine position and with normal breathing there was a spontaneous variation in the P wave amplitude of ± 15 per cent. P wave amplitude was only to a minor extent influenced by body position and maximum breathing movements. The threshold of stimulation was 1-7 ±0-7 V (impulse duration 0 5 mi) at the time of electrode insertion. It increased to 2 7 ± 1 0 V after four weeks. The electrode resistance varied about 600 ohms.A total of 28 patients received an atrial transvenous endocardial lead. Three electrode dislocations occurred, all during the first 24 hours; apart from these three, the electrodes were connected easily to the intended pacemakers and have functioned well during the observation period of between two and 24 months. In conclusion, the transvenous endocardial atrial lead Medtronic 6991 has shown attractive qualities. The electrophysiological data recorded are suitable for the pacemakers in use. So far this atrial lead seems promising and deserves further evaluation.Despite the increasing number of patients with pacemakers, there has not been a corresponding increase in the use of atrial synchronous and atrial inhibited pacing. In Sweden not more than 1 per cent of initially implanted pacemakers are atrial synchronous (Karlof and Lagergren, 1973; Edhag, 1977). Many patients would, however, improve haemodynamically with an atrial inhibited or atrial synchronous pacemaker (Lagergren et al., 1966;DeSanctis, 1971;Furman, 1973). The reason for the limited use of atrial pacing is probably the lack of an electrode which combines a simple technique of introduction with long-term reliability. Recently promising results have been reported by the use of a transvenous J-shaped atrial tined lead (Smyth et al., 1976;Kleinert et al., 1977). These reports deal with the technique of introduction and electrophysiological characteristics of the lead at the time of electrode insertion.The present investigation was undertaken to study the electrophysiological characteristics of the Received for publication 17 April 1979 atrial electrode by means of repeated measurements throughout a period of four weeks after the introduction of the electrode. The report also contains information about our present clinical experience with the electrode. Subjects and methods PATIENTSThe subjects consisted of 28 patients; pertinent data from these are pres...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

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Clinical and electrophysiological characteristics of a transvenous atrial lead.

Kruse¹,

Rydén²,

Ydse³

1979

Heart

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“…The J-shaped electrode was developed to hook into the right atrium when passed transvenously; because dislodgment was problem, tines were added (Fig. 4A) and favorable reports have followed (25). Both atrial and ventricular electrodes are required for atrial synchronous and AV sequential pacing.…”

Section: The Atrial Electrodementioning

confidence: 99%

Pacemakers, Cardiac Mapping and EEG in the Community Hospital: A Concise Review of Background and Basic Technical Considerations

Anderson¹,

Carney²

1979

Clinical Electroencephalography

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The heart is a pump. The objective of cardiac pacing is to improve the cardiac output. The most popular method of cardiac pacing (RV) is not physiologic and results in reduced stroke output when compared to that of normal sinus or atrial paced rhythm. Recognition of pacemaker induced low output states and pacemaker aggravated neurological symptoms has quickened interest in physiologic atrial pacing. The increased complexity of atrial pacing has been discouraging in the past, but technical advances in electrode and pacemaker design are promising. Selection of the optimal pacing site appears critical and requires the determination of the focal electrical potential and stimulating threshold before electrodes are positioned. With minimal expense, the EEG can be adapted for this type of cardiac mapping in the community hospital.

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A new atrial transseptal pacing electrode

Udall

1982

Clinical Cardiology

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Summary:The atrial septum provides a convenient structure to which a transvenous electrode can be attached securely. The Brockenbrough cardiac catheterization technique has been used to gain access to the left atrium. A new electrode has been fabricated which can be inserted into the left atrium through the lumen of a Brockenbrough catheter. The electrode is composed of a stainless steel coil attached inside the proximal end of a platinum cylinder at the cardiac terminal. Three Elgiloy wires, having a wing configuration, are attached inside the distal end of the platinum cylinder. The coil and cylinder are insulated by silicone rubber and the metallic surface area of the distal electrode tip equals 5 mm2. This electrode has been implanted without difficulty or complications in five patients with tachycardia-bradycardia syndrome.

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Clinical use of a new transvenous atrial lead

Cited by 40 publications

References 12 publications

Clinical and electrophysiological characteristics of a transvenous atrial lead.

Clinical and electrophysiological characteristics of a transvenous atrial lead.

Pacemakers, Cardiac Mapping and EEG in the Community Hospital: A Concise Review of Background and Basic Technical Considerations

A new atrial transseptal pacing electrode

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