Improved Technique in Permanent Atrial Pacing

Abstract

At the present time, the relatively high atrial stimulation threshold and the low and often unstable P wave amplitude are the main concerns in atrial pacing. As a further contribution to the solution of this problem we used a screw-in atrial lead in 16 patients. During the implantation, atrial mapping was performed in order to establish the position with the best electrical performance. The acute threshold for voltage at a pulse duration of 1 ms averaged 0.49 +/- 0.18 Volt. The acute peak-to-peak P wave amplitude averaged 4.6 mV +/- 1.3. No complication occurred at the time of the implantation. Follow-up periods averaged 12 months. No dislocation or bleeding was observed during a follow-up period of up to 28 months. Using this lead together with intraoperative atrial mapping, it is possible to achieve an acute strength-duration relationship in the atrium at a level similar to that in the ventricle. The results of this study demonstrate that intraoperative mapping is an important stein in enhancing the safety margins and long-term performance of atrial pacing.

Rapid Improvement and Long-term Stability of Pacing Threshold with Active-fixation Screw-in Lead

“…A trend toward increased use of active-fixation screw-in leads may be because of the following advantages: rapid implantation; low dislodgement rate; easy extraction; and ability to select any pacing site. [3][4][5][6][7][8][9][10][11][12] Using active-fixation screw-in leads, Bachmann bundle pacing could decrease the dispersion of atrial refractoriness and may lead to reduction in the incidence of atrial fibrillation. 8) If trans venous implantation via persistent left superior vena cava is intended, it is recommended to use active-fixation screw-in leads with a sufficient length so that a loop in the right atrium can be formed with appropriate fixation to the right ventricle.…”

Our Nuts and Bolts in The Permanent Pacemakers’ Explanation Techniques

“…There are two draw backs to these leads. The stability issues 14 one and two the explantation 15 if it is needed due to any reasons. Tined leads instead of having active fixing materials there are small tines that protrude backward just proximal to the tip, made of plastic materials, make these leads more difficult to position at the right ventricular apex as the tines tended to anchor on intracardiac structures.…”