2 YEAR EXPERIENCE WITH THE FRACTAL LEADS POLYROX PX 60-BP (VENTRICULAR) AND PX 52-JBP (ATRIAL). J. Van den Broek,* C. Drossos. Ballarat Health Services, Ballarat, Australia, and Biotronik, Australia. Recent pacemaker lead development has aimed to reduce energy consumption and ensure good detection of cardiac signal. The main priorities in low energy pacing are to reduce the inflammatory reaction at the lead tip, and to maximise the Electrochemically Active Surface area (EAS). Inflammatory reaction has been reduced by using biocompatible materials (Platinum alloys and Titanium) and the use of steroid eluting leads. Further reduction in stimulation threshold has been achieved with reduction in Geometrical Surface area (GSA), however this is limited with conventional leads in view of increasing resistance to charge transfer with reduction in EAS. Iridium fractal surface treatment increases EAS, with smaller GSA. Methods: We entered patients with usual indications to Cardiac Pacing in a prospective non randomised clinical investigation with an aim to follow up for 24 months. The Biotronik Polyrox PX 60-BP and PX53-JBP leads with an Iridium fractal surface were implanted. We present the data on 17 patients, (12 atrial leads and 17 ventricular leads) to 24 month follow up.
Conclusions: These thresholds were comparable to thresholds achieved with current steroid leads and maintained at 24 months, an initial rise was apparent due to early inflammation which was improving by 1 month and back to implant levels by 12 months. Advantages with this lead are low energy pacing, equivalent threshold in unipolar and bipolar stimulation, superior sensing with application to rate adaptive pacing algorithms, and may have novel applications such as early detection of cardiac transplant rejection. |
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