Combining current of injury and P-wave sensing optimized right atrial active-fixation leads implantation.

Abstract:

Background:Pacing parameters may influence pacing lead life and pacemaker life. This study sought to determine whether different right atrial active-fixation lead implantation parameters are associated with chronic pacing performance. Methods:A retrospective observational study was conducted on all consecutive patients implanted with an active-fixation atrial lead at our institution from July 2014 to October 2016. Atrial leads with a P-wave sensing of ≥2.0 mV, a pacing threshold of ≤1.0 V, and a lead impedance of 300-1,000 ohms were assigned as the optimized group, while atrial leads that did not meet these specifications were assigned as the conventional group. A total of 98 patients who received active-fixation atrial leads (55 patients were male, mean age was 63±12 years old) were studied, and the lead performance of 67 of these patients were optimized in 3 months. Results:In the multivariate analysis, current of injury [COI; COI10min, odds ratio (OR): 0.296, 95% confidence interval (CI): 0.093-0.939, P=0.039] and P-wave sensing (P10min, OR: 0.449, 95% CI: 0.265-0.762, P=0.003) were recorded at 10 minutes after lead fixation, and were considered predictors of lead optimized performance. The cut-off value of COI10min and P10min was 1.04 mV (sensitivity: 0.58 and specificity: 0.77) and 3.3 mV (sensitivity: 0.67 and specificity: 0.74), respectively, for predicting lead optimized performance after 3 months. COI10min ≥1.04 mV and P10min ≥3.3 mV were combined and considered as the predictable criteria, and the area under the ROC curve was 0.806 (sensitivity =0.70 and specificity =0.77). Conclusions:Optimized atrial lead performance at 3 months was predictable from COI10min ≥1.04 mV and P10min ≥3.3 mV.

journal_name

J Thorac Dis

authors

Chen MR,Zhang FL,Wang WW,Chen XH,Chen JH,Chen LL

doi

10.21037/jtd.2019.04.04

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1279-1286

issue

4

eissn

2072-1439

issn

2077-6624

pii

jtd-11-04-1279

journal_volume

11

pub_type

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