RT Journal Article
SR Electronic
T1 Durability of bipolar coaxial endocardial pacemaker leads compared with unipolar leads
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 25
OP 28
VO 61
IS 1
A1 Helguera, Marcelo E.
A1 Pinski, Sergio L.
A1 Maloney, James D.
A1 Woscoboinik, Javier R.
A1 Trohman, Richard G.
A1 Morant, Victor A.
A1 Wilkoff, Bruce L.
A1 Castle, Lon W.
YR 1994
UL http://www.ccjm.org/content/61/1/25.abstract
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.