Background: Active-fixation pacemaker leads seem to have advantages over passive-fixation ones, such as the possibility of pacing at various sites, low dislodgement rate, and they are easier to extract. Unexpectedly their popularity in European countries is not high.
Aim: The comparative estimation of acute electrical parameters between high-impedance fractal passive-fixation and traditional active-fixation leads. Second aim of the study was the evaluation of commonly used active- and passive-fixation leads in order to find the best solution for ambulatory implantation.
Methods: 35 patients received passive-fixation Biotronik Synox SX60BP pacemaker leads and 35 patients received active-fixation Biotronik YP60BP pacemaker leads. Intraoperative measurement of pacing threshold, impedance, R amplitude, and slew-rate were performed.
Results: The pacing threshold was statistically significant lower (p = 0.1) in passive-fixation "tined-tip" SX60BP group (0.45 vs. 0.63). In 3 active-fixation cases "exit block" with ineffective pacing occured in early post-operative period.
Conclusion: Active-fixation YP60BP electrodes should not be used for ambulatory implantation course.
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JACC Case Rep
January 2025
Division of Cardiology, Electrophysiology Section, Adult Congenital Arrhythmia Clinic, Emory University, Atlanta, Georgia, USA.
Background: The atrial switch procedure is accompanied by a very high rate of sinus node dysfunction. Baffle stenosis is a common problem with transvenous pacemaker leads in this scenario.
Case Summary: We present a first-in-human case of a leadless pacer (LP) in the left atrium in a patient with prior atrial switch for transposition and sinus node dysfunction complicated by multiple abandoned leads, superior baffle occlusion, and failed extraction.
Pediatr Cardiol
January 2025
Cardiothoracic Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
Lead strangulation is a dangerous complication of epicardial pacemaker insertion. This complication has been increasingly highlighted lately. Our institution has recently identified four cases over the past five years.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-Ku, Yokohama city, Kanagawa 236-0004, Japan.
Background: Coronary sinus (CS) lead placement in persistent left superior vena cava (PLSVC) cases is challenging because of the poor backup force of the guiding catheter within the enlarged CS. Active fixation Quadripolar leads (Attain Stability™ Quad 4798, Medtronic) can expand choice to CS branches with limited access; however, no cases of anchoring to the main body of the CS have been published to date.
Case Summary: We describe a case of cardiac resynchronization therapy pacemaker upgrade in a 79-year-old female who developed pacing-induced cardiomyopathy after pacemaker implantation via the right superior vena cava (SVC) for atrioventricular block eight years ago wherein PLSVC was revealed during the procedure.
Catheter Cardiovasc Interv
January 2025
Department of Cardiology, Ageo Central General Hospital, Saitama, Japan.
Background: Intravascular lithotripsy (IVL), that generates shockwaves through spark gap discharge between emitters, has been increasingly used to treat severely calcified coronary artery lesions. However, there is a question as to whether IVL has no electrical effects on endocardial tissues or cardiac implantable devices (CIEDs).
Aims: The aim of this study was to investigate the effects of IVL-induced intracardiac potentials on cardiac electrophysiology and CIEDs.
Pacing Clin Electrophysiol
January 2025
Second Division of Cardiology, Cardiac-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
This case details the successful implantation of a leadless pacemaker following the extraction of transvenous leads in a 72-year-old female patient with a complex cardiovascular history. The patient had undergone a series of cardiac interventions, including a recent percutaneous tricuspid valve repair with a metal clip implant due to severe regurgitation. After presenting with an infection at the pacemaker site, methicillin-resistant Staphylococcus hominis was identified, necessitating the removal of the entire pacing system.
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