Improved reliability of post-operative ventricular pacing by use of bipolar temporary pacing leads.

The study compared the clinical reliability of using a bipolar epicardial wire (6495, Medtronic) over a unipolar type (FEP15, Ethicon) for post-operative pacing in coronary artery surgery. Atrial and ventricular wires of both types were implanted in 18 patients. Sensitivities and pacing thresholds were tested for 5 consecutive days. Results show that pacing thresholds were better maintained with the bipolar wire in both atria and ventricles. However, sensing failures were frequent in the atrial position (34% vs 9.3% compared with unipolar). By contrast, in the ventricle, no sensing failures occurred (0% vs 17.6% compared with unipolar). Furthermore, sensing magnitude was significantly better (11.13+/-1.32 vs 5.65+/-0.53 mV, P<0.001). We conclude that a single 6495 bipolar wire is effective for temporary ventricular pacing, whilst double unipolar wires remain a useful strategy for securing atrial sensing and pacing.