Choosing the Device Generator and Leads: Matching the Device with the Patient

Malini Madhavan, David L. Hayes, Paul A. Friedman, Samuel J. Asirvatham

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations

Abstract

Several patient, device, and lead related characteristics should be considered prior to device implantation. Patient characteristics that determine the type of device implanted - single chamber, dual chamber or cardiac resynchronization therapy, include the underlying indication for pacing, presence of atrial arrhythmias, and indications for cardiac resynchronization. The implanting physician should also have a thorough understanding of lead design that affects lead performance, longevity, complications, and ease of extraction. Particular attention should be paid to the type of insulation, fixation mechanism, polarity, and compatibility of the generator and lead. Additional considerations for an implantable cardioverter-defibrillator (ICD) lead include sensing configuration (integrated vs. true bipolar) and defibrillation coil structure (single vs. dual). Coronary sinus leads should offer a low lead profile and flexibility to navigate the tortuous coronary venous system and stability to avoid dislodgement.

Original languageEnglish (US)
Title of host publicationCardiac Pacing, Defibrillation and Resynchronization
Subtitle of host publicationA Clinical Approach
PublisherWiley-Blackwell
Pages133-156
Number of pages24
ISBN (Print)9780470658338
DOIs
StatePublished - Dec 17 2012

Keywords

  • Active fixation
  • Backfilling
  • Coronary sinus lead
  • ICD coil
  • Isodiametric lead
  • Lead conductor
  • Lead insulation
  • Passive fixation
  • Polyurethane
  • Silicone
  • Steroid elution

ASJC Scopus subject areas

  • Medicine(all)

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