Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Technology D-AB06 - Cardiac Resynchronization - LV and His Bundle Pacing! (ID 25) Abstract

D-AB06-03 - A Novel Single Conduit Lead For Av Sequential Pacing And Unique Conduction System Capture: Can Atrial And His Bundle Capture Be Achieved From A Single Location? (ID 1437)


Background: Current tools for physiologic pacing (PP) are limited.
Objective: Proof-of-concept multielectrode lead to provide multiple pacing options/stimulation targets from a single location.
Methods: A new concept for PP consists of a multipronged central helix single conduit lead (MPL) to be implanted into Koch’s triangle (Fig.1) followed by selection of the best electrode subsets. Prototypes 1.0 and 2.0 have been produced. Open chest (prototype 1.0) and transvenous (prototype 2.0) experiments have been performed in 9 pigs. Acute prototype lead placement was guided by EGM’s, electro-anatomical mapping and X-ray. Modified standard delivery sheaths were used. Subacute experiment was attempted in 1 animal.
Results: Differential capture of atrial tissue or His bundle is possible from a single implant location from different individual electrodes of a single conduit MPL thus providing dual chamber pacing capabilities.The prototype lead was successfully implantable into Koch’s triangle via a transvenous route; it remained in place for the duration of the acute and subacute experiment. Different variants of His bundle capture with different capture thresholds from individual electrodes are achievable with MPL. Pathology shows tissue penetration of the distal screw and individual prongs of MPL.
Conclusion: 1. MPL allows for PP with AV sequential capabilities from a single location. 2. This technology may obviate the need for two leads to be implanted separately so as to simplify the implant procedure. 3. Leadless concepts can be pursued. 4. Chronic animal and human studies are planned to prove these potential capabilities.