Six Years' Experience with Atrial Leads

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Abstract
This report describes a six-year experience with atrial leads consisting of 329 unipolar and 12 bipolar leads implanted in 302 patients. A variety of lead types were used: passive fixation with preformed J (including tines or fins in a solid electrode); porous tip electrodes with small tines, most of which were also preformed; active fixation leads (both straight and preformed); and finally bipolar leads, which were all preformed. No statistical differences were found between the P waves recorded from various unipolar leads. Similarly, there were no statistical differences found between voltage or energy thresholds between the different types of leads. The complication rate included 6.3% of early complications and 4.7% late complications for a total complication rate of 11%. This compares to a complication rate of 2% for ventricular leads. Thus, the complication rate of atrial leads is higher than ventricular leads; this must be considered when selecting a pacemaker system for a given patient.

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