Early Follow‐Up of Lead Performance in Atrioventricular Sequential Systems

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Abstract
Recent developments in pacemaker technology led us to report our initial and follow‐up assessment of atrioventricular (A‐V) sequential systems in 50 consecutive patients. Primary indications for pacing were sinus node dysfunction or A‐V block. Leads were introduced through the subclavian vein. Atrial J‐tined leads (27 silicone, 19 urethane) were positioned in the atrial appendage or stump in 46 patients, and coronary sinus or Bisping leads were placed in 4 patients; all 50 patients had tined ventricular leads. A Medtroric 5992 generator was placed in 35 patients and an Intermedics 259–01 generator in 15. Median implantation time was 105 minutes. Complications requiring reoperdtion in 409 patient‐nnonths of follow‐up included lead retraction (one patient), phrenic nerve stimulation (one), pseudofracture (one), and atrial lead‐induced “cross talk” (one). Monthly telephone transmission confirmed atrial capture in 35 patients and loss of capturein 1; the remainder had no identifiable P wave. Ventricular capture was confirmed in all. Postimplant and follow‐up checks showed good stability of lead positions. We conch de that these systems have a low incidence of problems in short‐term followup. (PACE, Vol. 5, September‐October, 1982)