Comparison of Vitreous Carbon and Elgiloy Transvenous Ventricular Pacing Leads

Abstract

In a randomized prospective study of 150 patients, we compared two porous-tipped, finned leads, one with a vitreous carbon tip (surface area = 12 mm2) and the other with an Elgiloy tip (surface area = 8 mm2). We assessed the acute and chronic stimulation thresholds and the ease of implantation of the two leads. The acute current thresholds for the vitreous carbon and Elgiloy-tipped leads were 1.7 +/- 0.5 (+/- SD) mA vs. 1.1 +/- 0.4 mA (0.25 ms pulse width), 1.3 +/- 0.5 mA vs. 0.9 +/- 0.3 mA (0.5 ms), and 1.0 +/- 0.3 mA vs. 0.8 +/- 0.3 mA (0.75 ms), respectively (P less than 0.0005). Impedance at implantation was 473 +/- 121 ohms and 716 +/- 285 ohms (P less than 0.0005) for the carbon-tipped and Elgiloy-tipped leads, respectively. The R-wave amplitudes were 10.2 +/- 5.1 volts and 6.8 +/- 3.0 volts, respectively (P less than 0.0005). Both leads were easy to implant and showed low stable chronic thresholds from 3 weeks after implantation, at which time the stimulation threshold was 1.9 +/- 1.0 volts vs. 1.5 +/- 0.6 volts with the implanted voltage-variable generators and 1.8 +/- 0.8 mA vs. 1.6 +/- 0.6 mA with the implanted current-variable generators. Reoperation for displacement was required for two of the 87 (2.3%) carbon-tipped and 2 of the 67 (3.2%) Elgiloy-tipped leads. There was no exit block nor any other lead-related complication. We conclude that both leads have similar and satisfactory performance.

Evaluation of Fractal‐Coated Temporary Pacing Leads in the Early Postoperative Course

“…The performance of widely used, conventional stainless steel electrodes is still limited by capture and sensing problems in the early postoperative period 5,6,7 . In the field of permanent implantable pacing leads, porous fractal Iridium surface coating of the tip can enhance electrical properties and long‐term reliability through decreasing polarization artifact and tipscarring 8–10 . Thus fractal coating of temporary pacing wires may lead to lower pacing thresholds and better long‐term reliability.…”