Difference in Cardiac Electrical Vulnerability Between Passive Silicone Steroid Eluting Lead vs. Active Screw-in Lead

Abstract

Patients with total atrioventricular block are of particular interest and prone to severe prognosis unless treated with emergency cardiac pacing. We evaluated different types of leads and their impact on the myocardium, according to the fixation type and pacing method.. A pacemaker patient has a different depolarization pattern and a single chamber pacemaker, has by definition, an intracardiac desynchronization and a different electro-mechanical coupling activity. The presence of late potentials is an independent prognosis factor for cardiac death and electrical vulnerability, especially after myocardial infarction(MI). Late potentials recorded as magnitude vector are the expresion of late depolarization of the surrounding tissue and represent the morfological substrate for reentry. Thus, the incidence of late potentials after pacemaker implant, represents the expresion of electrical vulnerability of the stimulated right ventricular myocardium. In order to deeply study the parameters of magnitude vectors, we noticed the appearance of late potentials during the transitory stimulation in acute atrioventricular block and a restoration of vector normal parameters, after conduction recovery and sinus rhythm conversion.