Comparative Thrombogenicity of Pacemaker Leads

Abstract

To evaluate the thrombogenicity of transvenous silicone and polyurethane pacemaker leads, 9 of 12 anesthetized Yorkshire pigs (27-32 kg) were implanted with silicone (n = 5) or polyurethane (n = 4) pacemaker leads via a femoral vein. The remaining three pigs served as controls. All 12 pigs were injected with autologous indium-111 labeled platelets (300-420 muCi) 24 hours before anesthesia induction. The pigs were monitored for 3 hours under a gamma camera. Radioactivity in blood and lead segments was measured with a gamma counter. Platelet deposits were denser on silicone leads (441.58 +/- 915.0 to 2.19 +/- 2.07) than on polyurethane leads (1.21 +/- 1.33 to 0.27 +/- 0.14) (P > 0.05). Denser platelet deposits were detected at the tip of all leads. Density of platelet deposits declined from tip to distal segments in silicone leads. The percentage of injected platelet radioactivity in the lungs of pigs with either silastic leads (12.9 +/- 2.3%) of polyurethane leads (10.1 +/- 2.2%) was higher than in the controls (4.6 +/- 0.5%) (P < 0.05). This difference indicates thrombus formation and embolization in the lungs early after lead implantation. Thrombogenicity of polyurethane leads may be lower than that of silicone leads.

Left Ventricular Endocardial Pacing: A Transarterial Approach

“…In a previous animal study, assessing leads in the right ventricle, the mean density of platelet deposits on silicone leads appeared more pronounced on silicone leads compared to polyurethane leads. Our study results are consistent with this study, which demonstrated a relative thromboresistance of polyurethane leads 9 …”

Comparison of catheter thrombogenicity in a modified chandler loop model using goat blood

“…Using this model, we have demonstrated significantly lower thrombus weights and infusion pressures for polyurethane catheter material as compared to silicone catheters. The observed differences between polyurethane and silicone catheter material in this in vitro model , indicating the silicone catheter tested here is more thrombogenic than the polyurethane catheter, are consistent with relative thrombogenicity of similar materials observed both in vitro and in vivo in most . but not all, previous reports comparing the thrombogenicity of these two materials.…”

Permanent Transvenous Left Ventricular Endocardial Pacing in a Patient with Univentricular Atrioventricular Connection

“…5 In this context, when careful postprocedural anticoagulation is adhered to, there have been no reported cases of thromboembolism in published series. 7 In addition, endocardial pacing has some potential advantages over epicardial pacing, including lower chronic pacing thresholds with resulting increased battery longevity, as well as a reduction in pacing-induced QT dispersion. 7 In addition, endocardial pacing has some potential advantages over epicardial pacing, including lower chronic pacing thresholds with resulting increased battery longevity, as well as a reduction in pacing-induced QT dispersion.…”