Effect of Steroid Elution on Electrical Performance and Tissue Responses in Quadripolar Left Ventricular Cardiac Vein Leads

Autor:	Nicole Kirchhof, Zhongping Yang, Douglas S. Hine, Rick D. McVenes, Shelby Li
Rok vydání:	2015
Předmět:	Male medicine.medical_specialty Percutaneous Heart Ventricles medicine.medical_treatment Cardiac resynchronization therapy Paired comparison Dexamethasone Veins Dogs Internal medicine medicine Animals Ventricular Function Electrical performance Lead (electronics) Glucocorticoids Histological examination Cardiac Vein business.industry General Medicine Electrodes Implanted medicine.anatomical_structure Ventricle Cardiology Female Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 38:966-972
ISSN:	1540-8159 0147-8389
DOI:	10.1111/pace.12624
Popis:	Introduction The use of steroid elution (SE) electrode in a cardiac pacing lead is known to suppress myocardial inflammation to lower pacing thresholds (PTs). SE has been widely utilized on the distal electrode of left ventricular cardiac vein (LVCV) leads used in cardiac resynchronization therapy (CRT). However, no paired comparison in effect of SE has been studied in proximal electrodes of quadripolar LVCV leads. Methods We evaluated electrical performance and tissue responses of quadripolar LVCV lead electrodes with and without SE in two canine studies with a total of 14 canines. Extended bipolar PT and pacing impedance of the LVCV electrodes to right ventricle coil were collected via an implantable CRT device/programmer or a percutaneous threshold analyzer/pacing analyzer at weeks 0, 1, 2, 4, 6, 8, and 12. Gross and histopathological examinations of the canines were performed at the end of the studies. Results Our preclinical studies showed that SE had significant effects on the long-term pacing performance of quadripolar LVCV leads. The SE tip and ring electrodes reduced postimplant PT peak and chronic PT, P = 0.038. Histological examination of the perilead tissue capsules at 12 weeks showed a reduced thickness for the location of SE electrodes. Conclusion SE electrodes in quadripolar LVCV leads lower the PTs, and therefore may potentially reduce long-term current drain of CRT systems, thus improving the device longevity. These preclinical data serve as rationale to include SE on proximal electrodes for the Attain Performa LVCV leads and future quadripolar LVCV leads development.
Databáze:	OpenAIRE
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