Comparison between latest generation steroid-eluting screw-in and tined leads. Long term follow-up

An Italian multicenter study was conducted on 180 patients in order to evaluate the long-term performances of latest generation steroid-eluting, screw-in vs. tined leads in the atrium (A) and in the ventricle (V). Single and dual-chamber Medtronic Thera pacemakers were implanted with 235 Medtronic Capsure Z tined leads (111 A and 124 V) and 100 Medtronic Capsure Fix screw-in leads (48 A and 52 V). Follow-up visits at 24 hour, 1, 3, 6, and 12 month post-implant were performed. Tined leads showed a significantly lower threshold (at 1.6 V) and higher pacing impedance than screw-in leads in both chambers. The sensing values, however, were similar. At the 1 year follow-up, both leads gave good electric performances thus permitting low energy stimulation. No significant differences were found between bipolar and unipolar models. In a small percentage of patients (12 patients) implanted with screw-in leads, we compared the acute/chronic pacing thresholds and impedance values recorded either in the right ventricular outflow tract or in the right apex and we found no statistical difference between the two examined pacing sites.