PT  - JOURNAL ARTICLE
AU  - Helguera, Marcelo E.
AU  - Pinski, Sergio L.
AU  - Maloney, James D.
AU  - Woscoboinik, Javier R.
AU  - Trohman, Richard G.
AU  - Morant, Victor A.
AU  - Wilkoff, Bruce L.
AU  - Castle, Lon W.
TI  - Durability of bipolar coaxial endocardial pacemaker leads compared with unipolar leads
DP  - 1994 Jan 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 25--28
VI  - 61
IP  - 1
4099  - http://www.ccjm.org/content/61/1/25.short
4100  - http://www.ccjm.org/content/61/1/25.full
SO  - Cleve Clin J Med1994 Jan 01; 61
AB  - BACKGROUND The coaxial design allows for thinner bipolar endocardial pacemaker leads, but recent reports have suggested a higher incidence of failure for this sophisticated configuration.OBJECTIVE To compare the long-term survival of bipolar coaxial and unipolar leads.METHODS Retrospective follow-up.RESULTS Between January 1, 1980 and June 30, 1991, 1142 bipolar coaxial leads and 1181 unipolar leads were implanted at the Cleveland Clinic. The mean follow-up was 33 ± 32 months (range 1 to 138 months). Ten bipolar coaxial leads failed (0.88%), as did 9 unipolar leads (0.76%). At 5 years the cumulative survival was 98.6% for both types of leads; however, at 10 years the survival of bipolar coaxial leads was only 92.4% compared with 98.6% of unipolar leads (P = .03; relative risk 2.7, 95% confidence interval = 1.1 to 6.9).CONCLUSIONS The sophisticated design of bipolar coaxial leads could be the cause of their increased vulnerability. The benefit- to-risk ratio of this design should be prospectively reevaluated.