The Electrode‐Tissue Interface: The Revolutionary Role of Steroid‐Elution

Mond, Harry G.; Helland, John; Stokes, Ken; Bornzin, Gene A.; McVenes, Rick

doi:10.1111/pace.12461

Cited by 46 publications

(38 citation statements)

References 62 publications

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“…Current drain, in turn, is measured in amperes and for pacemakers refers to the current utilized with each paced or sensed event. During cardiac pacing, the current drain is very dependent on the impedance within the pacemaker circuit and in particular the characteristics of the cathode electrode …”

Section: The Chemical Batterymentioning

confidence: 99%

The Cardiac Implantable Electronic Device Power Source: Evolution and Revolution

Mond

Freitag²

2014

Pacing Clinical Electrophis

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Although the first power source for an implantable pacemaker was a rechargeable nickel-cadmium battery, it was rapidly replaced by an unreliable short-life zinc-mercury cell. This sustained the small pacemaker industry until the early 1970s, when the lithium-iodine cell became the dominant power source for low voltage, microampere current, single- and dual-chamber pacemakers. By the early 2000s, a number of significant advances were occurring with pacemaker technology which necessitated that the power source should now provide milliampere current for data logging, telemetric communication, and programming, as well as powering more complicated pacing devices such as biventricular pacemakers, treatment or prevention of atrial tachyarrhythmias, and the integration of innovative physiologic sensors. Because the current delivery of the lithium-iodine battery was inadequate for these functions, other lithium anode chemistries that can provide medium power were introduced. These include lithium-carbon monofluoride, lithium-manganese dioxide, and lithium-silver vanadium oxide/carbon mono-fluoride hybrids. In the early 1980s, the first implantable defibrillators for high voltage therapy used a lithium-vanadium pentoxide battery. With the introduction of the implantable cardioverter defibrillator, the reliable lithium-silver vanadium oxide became the power source. More recently, because of the demands of biventricular pacing, data logging, and telemetry, lithium-manganese dioxide and the hybrid lithium-silver vanadium oxide/carbon mono-fluoride laminate have also been used. Today all cardiac implantable electronic devices are powered by lithium anode batteries.

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Section: The Chemical Batterymentioning

confidence: 99%

The Cardiac Implantable Electronic Device Power Source: Evolution and Revolution

Mond

Freitag²

2014

Pacing Clinical Electrophis

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“…5,6 As previously described and shown in Figure 1, the LP retrieval catheter system is inserted via the femoral vein and includes a deflectable tip (>180°) with either a single-loop or triple-loop snare and an integrated protective sleeve. 3 There are 3 separate mechanisms that control tip deflection, snare closure, and LP docking to the retrieval catheter.…”

Section: Methodsmentioning

confidence: 99%

Retrieval of the Leadless Cardiac Pacemaker

Reddy

Miller

Knops

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Leadless cardiac pacemakers have emerged as a safe and effective alternative to conventional transvenous single-chamber ventricular pacemakers. Herein, we report a multicenter experience on the feasibility and safety of acute retrieval (<6 weeks) and chronic retrieval (>6 weeks) of the leadless cardiac pacemaker in humans. Methods and Results-This study included patients enrolled in 3 multicenter trials, who received a leadless cardiac pacemaker implant and who subsequently underwent a device removal attempt. The overall leadless pacemaker retrieval success rate was 94%: for patients whose leadless cardiac pacemaker had been implanted for <6 weeks (acute retrieval cohort), complete retrieval was achieved in 100% (n=5/5); for those implanted for ≥ 6 weeks (chronic retrieval cohort), retrieval was achieved in 91% (n=10/11) of patients. The mean duration of time from implant to retrieval attempt was 346 days (range, 88-1188 days) in the chronic retrieval cohort, and nearly two thirds (n=7; 63%) had been implanted for >6 months before the retrieval attempt. There were no procedure-related adverse events at 30 days post retrieval procedure. Conclusions-This

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“…[12][13][14][15] Typically, there is thrombus formation, localized inflammatory process with granulation tissue and gradual replacement with fibrous tissue. Defibrillation leads incite a greater fibrotic reaction compared with pacemaker leads.…”

Section: Discussionmentioning

confidence: 99%

Acute and Chronic Performance Evaluation of a Novel Epicardial Pacing Lead Placed by Percutaneous Subxiphoid Approach in a Canine Model

John

Morgan

Brennecke

et al. 2015

Circ: Arrhythmia and Electrophysiology

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The basic design for the intrapericardial leads (IPLs) used a diamond-shaped loop for stability at the distal end and a preshaped lead body within the diamond loop in which the bipolar, nonsteroid eluting, electrodes were located (Figure 1). The electrodes were titanium nitride-coated platinum iridium, 5 mm 2 in dimension © 2015 American Heart Association, Inc. Original ArticleBackground-Endovascularly implanted leads risk vascular injury and endocarditis, and can be difficult to locate in desired positions for LV pacing. We evaluated the acute and long-term stability, electric performance and histopathology of a percutaneously placed intrapericardial lead (IPL). Methods and Results-Twelve adult mongrel dogs underwent defibrillator implants incorporating IPLs. Successful uncomplicated percutaneous implantation of an IPL was achieved in all. Early fluoroscopic shift noted with 3 of 6 of the initial version IPL-1 was not seen with the modified IPL-2. Mean±95% confidence interval bipolar capture threshold at 0.5-ms pulse width for the IPL increased from 0.69±0.14 V at implant to 1.50±0.34 V (P=0.003) at 12 weeks. The 12-week thresholds were higher for IPL compared with right ventricular endocardial leads (0.75±0.33 V; P=0.001) but not different compared with coronary sinus leads (1.33±0.58 V; P=0.994). IPL impedance increased from 742±46 Ω at implant to 1066±207 Ω at 12 weeks (P=0.007). R-wave amplitude at 12 weeks was 8.37±1.52 mV. There was no important phrenic nerve stimulation from IPL pacing. Histopathology in 8 animals showed adequate adhesion of the electrodes or mesh to the epicardium without damage to underlying vasculature. There was no evidence for late pericardial inflammation or effusion. Conclusions-The IPL demonstrated adequate stability of position and acceptable electric parameters without chronic pericardial inflammation in this canine model and offers a potential alternative to endocardial pacing leads.

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The Electrode‐Tissue Interface: The Revolutionary Role of Steroid‐Elution

Cited by 46 publications

References 62 publications

The Cardiac Implantable Electronic Device Power Source: Evolution and Revolution

The Cardiac Implantable Electronic Device Power Source: Evolution and Revolution

Retrieval of the Leadless Cardiac Pacemaker

Acute and Chronic Performance Evaluation of a Novel Epicardial Pacing Lead Placed by Percutaneous Subxiphoid Approach in a Canine Model

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