| Autor: |
Gillis, Anne M., Hillier, Karen R., Rothschild, John M., McDonald, Margot, Simpson, Clifford A., George Wyse, D., Fauchon, Beverley J. |
| Předmět: |
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| Zdroj: |
Pacing & Clinical Electrophysiology; May1997, Vol. 20 Issue 5, p1274-1282, 9p |
| Abstrakt: |
The suboptimal performance of some polyurethane bipolar pacing leads has highlighted concern about the optimal method of monitoring pacemaker lead performance. Since the manifestations of premature lead failure may be initially intermittent, we hypothesized that ambulatory electrocardiography (AEGG) would be a more sensitive tool for the detection of pacing lead failure compared to increased pacemaker clinic surveillance. Since the Medtronic safety alerts on the 4012, 4082, and 4004 leads, we have followed 261 patients by serial AECG and 165 patients by increased pacemaker clinic surveillance. Lead failures were identified in 75 patients: 68 in the AEGG group (31 %) and 7 in the clinic group (4%, P <0.001). Repeat AECG confirmed the lead failure in 38(97%) of 39 patients in which it could be done. Pacing lead failure documented by AECG could be confirmed by a subsequent clinic assessment in only 15 (25%) of 60 patients evaluated (P <0.001). The actuarial survival of the 4012 lead was significantly lower in the AECG group compared to the clinic group (56% vs 87% survival at 8 years, P <0.002). Similar trends were observed for the 4082 and 4004 leads. AEGG is a more sensitive method of surveillance for pacemaker lead function compared to pacemaker clinic assessment. AEGG should be in corporated in to the routine follow- up of pacemaker patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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