14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-129

The first experience with the new Biotronik coronary sinus designed lead

Andrzej Kutarski, Max Schaldach*, Maciej Wójcik, Krzysztof Oleszczak, Krzysztof Poleszak, Teresa Widomska-Czekajska.
Department of Cardiology, Medical University Academy, Lublin, Poland, *Department of Biomedical Engineering, University of Erlangen-Nuremberg, Germany

Abstract

Coronary sinus (CS) stays an important place for lead location, especially in aspects of multisite atrial pacing. Its unsolved till now problem remain high frequency of lead dislocation (over 10%). Our long term experience with left atrial (LA) pacing indicated that it can be paced from the ring-electrode standard BP lead; its tip with tines can serve anchoring role. It brought us to construction of special lead designed for permanent CS pacing. The inactive part with its longer tines was prolonged up to 6 cm for fixation in narrow cardiac vein. The areas both of rings (located 6 and 9,5 cm from the tip) were reduced in following models. We implanted the new special BIOTRONIK CS lead in 84 pts with BRT syndrome (92%) and AV block (8%). In 33 of them leads were classically connected with pacemaker and in 51 inverted split BP biatrial (BiA) pacing system was applied. All implantation were successful. Acute and chronic sensing conditions were satisfied (LA wave over 2 mV) especially in BP configuration; pacing threshold (PTh) values were stable (about 3V) with decreasing tendency during 1 year of follow-up. Only one (1%) dislocations of CS lead were observed and in none phrenic nerve pacing or exit block were noted. Observations support the usefulness of our initial concept of prevention CS lead dislocation with long anchoring strand; we believe that some modifications will further decrease PTh.

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