Peter P Karpawich
The Children’s Hospital of Michigan, USA
Title: Ten year performance of the 4.1 French, lumenless, catheter-delivered pacing lead among patients with and without congenital heart
Biography
Biography: Peter P Karpawich
Abstract
Introduction: The lumenless, 4.1F diameter M3830 steroid pacing lead (Medtronic, Inc.) is a coaxial, solid core, non-styletdelivered design. Approved for use in 2005, the very long term performance is largely unknown, especially among congenital heart disease (CHD) pts and with implant at alternate (non appendage/apex) pacing sites (AP). This study presents 10 year post implant evaluation of this lead among CHD pts. Methods: From 2005-2015, 126 pts (age 2-50, mean 19y, 58% male) received 190 leads: atrial 105; ventricle 85. CHD pre-/postrepair structural anatomy (73%) included septal defects, tetralogy and transposition with 93% implant at AP (e.g. septal). Data included sensing, pacing thresholds and lead impedances (Imp). Results: Follow-up was from 1-120 months (mean 60) with >50% of pts followed > 5 y post implant. Comparative implant with latest follow-up showed excellent < 1v) pacing thresholds (volts at 0.4-0.5ms) graph): atrial (A) (0.70±0.3 vs. 0.63±0.3 vs. (P=NS)) and ventricular (V) (0.64±0.3 vs. 0.89±0.4 vs. (p<0.05)) and sensed P (mean 3.5±1.9 vs. 3.6±2mv (NS) and R waves (10.6±5 vs. 9.6±4.8mv (NS). Lead Imp were all in the normal range for lead design (A: 745±223 vs. 556±121 Ω: V 845±255 vs. 522±82 Ω (p < 0.05). Only 2 A leads dislodged (< 1 month) and one was repositioned and 2 other leads (1 A, 1 V) were extracted. Conclusions: The 4.1Fr, lumenless pacing lead shows ease of implant regardless of CHD or site, excellent very long term (10y) stability and performance indices with a very low rate of complications.
