Pacemaker wires and electrodes. A follow-up study.

Abstract

In 362 patients on permanent pacing, a follow up with regard to pacemaker electrode function time and connection to pulse-generators has been carried out. In 12 patients Elema epicardial electrode were used with an average function time of 3.8 years. 232 Elema EMT 588 endocardial electrodes were used in 216 patients. Average observation time for the electrodes was 3.3 years. Sixty-eight electrodes have been followed for more than 5 years. Early electrode complications comprise 10 per cent of displacements before implantation of the pulse-generator and another 6 per cent of electrode displacements within the first 3 months after implantation. Eleven per cent of the electrodes had to be corrected due to high threshold value before implantation and another 6 per cent during the first 3 months after implanattion of pulse-generator. On hundred and fifty-five unipolar electrodes of the types Cordis, Medtronic, Elema EMT 282, and Stanium were implanted in 149 patients. Average observation time for the electrodes were 1.2 years. During the first 3 months after pacemaker implant 7 per cent of the electrodes were dislocated, 5 per cent failed due to high threshold value. Three perforations of the right ventricle occurred, without serious complications. Late complications i.e. after 3 months, for EMT 588 electrode included 4 per cent electrode dislocations, 4.5 per cent failure due to high threshold, 3 cases of wire break and 4 defects in the insulation. Many of the late electrode complications were probably caused by replacement operations for pulse-generators. The most frequent late complications for the conventional unipolar electrode was wire break which occurred in 5 cases.