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Salih A, Goswami T. In Vivo Durability of Polyurethane Insulated Implantable Cardioverter Defibrillator (ICD) Leads. Polymers (Basel) 2024; 16:1722. [PMID: 38932072 PMCID: PMC11207236 DOI: 10.3390/polym16121722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
The 6935M Sprint Quattro Secure S and 6947M Sprint Quattro Secure are high voltage leads designed to administer a maximum of 40 joules of energy for terminating ventricular tachycardia or ventricular fibrillation. Both leads utilize silicone insulation and a polyurethane outer coating. The inner coil is shielded with polytetrafluoroethylene (PTFE) tubing, while other conductors are enveloped in ethylene tetrafluoroethylene (ETFE), contributing to the structural integrity and functionality of these leads. Polyurethane is a preferred material for the outer insulation of cardiac leads due to its flexibility and biocompatibility, while silicone rubber ensures chemical stability within the body, minimizing inflammatory or rejection responses. Thirteen implantable cardioverter defibrillator (ICD) leads were obtained from the Wright State University Anatomical Gift Program. The as-received devices exhibited varied in vivo implantation durations ranging from less than a month to 89 months, with an average in vivo duration of 41 ± 27 months. Tests were conducted using the Test Resources Q series system, ensuring compliance with ASTM Standard D 1708-02a and ASTM Standard D 412-06a. During testing, a load was applied to the intact lead, with careful inspection for surface defects before each test. Results of load to failure, percentage elongation, percentage elongation at 5 N, ultimate tensile strength, and modulus of elasticity were calculated. The findings revealed no significant differences in these parameters across all in vivo exposure durations. The residual properties of these ICD leads demonstrated remarkable stability and performance over a wide range of in vivo exposure durations, with no statistically significant degradation or performance changes observed.
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Affiliation(s)
- Anmar Salih
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA;
| | - Tarun Goswami
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA;
- Department of Orthopedic Surgery, Sports Medicine and Rehabilitation, Miami Valley Hospital, Dayton, OH 45409, USA
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Salih A, Goswami T. Mechanical Behavior of Polyurethane Insulation of CRT Leads in Cardiac Implantable Electronic Devices: A Comparative Analysis of In Vivo Exposure and Residual Properties. Bioengineering (Basel) 2024; 11:156. [PMID: 38391642 PMCID: PMC10885934 DOI: 10.3390/bioengineering11020156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/19/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Left ventricle leads are designed for the purpose of long-term pacing in the left ventricle. This study investigated the leads that use polyurethane as an outer insulator and SI-polyimide as an inner insulator. Polyurethane is commonly used for the outer insulation of cardiac leads due to its flexibility and biocompatibility. SI-polyimide (SI-PI) is a high-performance material known for its electrical insulation properties and is used for the inner insulation to maintain the integrity of the electrical pathways within the lead. Ten leads were received from the Wright State University Anatomical Gift Program. The duration of in vivo implantation varied for each lead, from less than a month to 108 months, with an average in vivo duration of 41 ± 31 months. We used the Test Resources Q series system for conducting our tests, as well as samples prepared to ensure compliance with the ASTM Standard D 1708-02a and the ASTM Standard D 412-06a. During the test, the load was applied to the intact lead. Before conducting individual tests, each lead was carefully inspected for surface defects. After conducting the tests, the load to failure, percentage of elongation, percentage of elongation at 5 N, ultimate tensile strength, and modulus of elasticity were calculated. There was no significant difference in load to failure, the percentage of elongation to failure, ultimate tensile strength, and modulus of elasticity (p-value = 0.82, p-value = 0.62, p-value = 0.82, and p-value = 0.12), respectively, when compared to in vivo exposure time. On the other hand, the percentage of elongation at 5 N force showed a significant difference (p-value = 0.0066) after 60 months in an in vivo environment. As the duration of in vivo exposure increased, the load to failure, percentage of elongation, ultimate tensile strength, and modulus of elasticity decreased insignificantly. The residual properties of these left ventricle leads remained relatively stable after 108 months of in vivo exposure duration, with no statistically significant degradation or changes in performance.
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Affiliation(s)
- Anmar Salih
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
| | - Tarun Goswami
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
- Department of Orthopedic Surgery, Sports Medicine and Rehabilitation, Miami Valley Hospital, Dayton, OH 45409, USA
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Bonner M, Hilpisch K, Wika K, Mesich ML, Harris M, White T. Visual observation of extraction of a Micra leadless pacemaker from a human cadaver. Pacing Clin Electrophysiol 2022; 45:1056-1061. [PMID: 35766651 PMCID: PMC9796770 DOI: 10.1111/pace.14559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION In this article we present the extraction of a Micra from a human cadaver implanted 3 years previously with both visual and X-ray imaging taken during the removal. METHODS A Micra pacemaker was extracted from a human cadaver with endoscopy and fluoroscopy using a Micra delivery tool. Histological analysis was performed on slices from the tissue surrounding the Micra. RESULTS The fully encapsulated Micra was easily retrieved with a maximum force of 1.9 pounds. CONCLUSIONS Even though the Micra was implanted almost 3 years previously, the snaring and extraction of the Micra was performed relatively easily and with minimal force required.
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Affiliation(s)
- Matthew Bonner
- Medtronic Cardiac Rhythm ManagementMinneapolisMinnesotaUSA
| | | | - Kent Wika
- Medtronic Physiological Research LaboratoriesMinneapolisMinnesotaUSA
| | | | - Megan Harris
- Medtronic Cardiac Rhythm ManagementMinneapolisMinnesotaUSA
| | - Troy White
- Medtronic Cardiac Rhythm ManagementMinneapolisMinnesotaUSA
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Bongiorni MG, Burri H, Deharo JC, Starck C, Kennergren C, Saghy L, Rao A, Tascini C, Lever N, Kutarski A, Fernandez Lozano I, Strathmore N, Costa R, Epstein L, Love C, Blomstrom-Lundqvist C, Fauchier L, Defaye P, Arnar DO, Klug D, Boveda S, Nielsen JC, Boriani G, Zhang S, Martin AP, Prutkin JM, de Zuloaga C. 2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS/HRS/LAHRS. Europace 2018; 20:1217. [DOI: 10.1093/europace/euy050] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/01/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Haran Burri
- Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean C Deharo
- Department of Cardiology, CHU la Timone, Marseilles, France
| | - Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| | - Charles Kennergren
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laszlo Saghy
- Electrophysiology Division, 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | | | - Carlo Tascini
- First Division of Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Nigel Lever
- APHRS Reviewer, Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | | | | | - Neil Strathmore
- APHRS Reviewer, Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | - Roberto Costa
- LAHRS Reviewer, Hospital das Clínicas, São Paulo, Brazil
| | - Laurence Epstein
- HRS Reviewer, Clinical Cardiac Electrophysiology, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Charles Love
- HRS Reviewer, Division of Cardiovascular Medicine, the Ohio State University Medical Center Columbus, Ohio, USA
| | | | | | - Pascal Defaye
- CHU Hopital Albert Michallon, Unite de Rythmologie Service De Cardiologie, Grenoble, France
| | - David O Arnar
- Landspitali University Hospital, Cardiology Department, Reykjavik, Iceland
| | - Didier Klug
- Hopital Cardiologique, Chru Lille, Service De Cardiologie A, Lille, France
| | - Serge Boveda
- Clinique Pasteur, Cardiology Department, Toulouse, France
| | - Jens Cosedis Nielsen
- Department of Cardiology, Aarhus University Hospital, Skejby Sygehus, Aaehus, Denmark
| | | | - Shu Zhang
- Beijing Fuwai Hospital, Cardiology Department, Beijing, China
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