Survey of ST-Segment Changes due to Active Lead Fixation during Permanent Pacemaker Device Implantation as a Prognostic Indicator of its Performance

Active lead implantation can create injury in myocardium that may be associated with a ST-segment elevation. This ST-segment elevation may be correlated with changes in other parameters such as threshold, sense, amplitude, impedance, and sensitivity. But, the relationship between the numerical elevating of ST-segment with permanent pacemaker device performance is not clear.
In this prospective cohort study, census sampling method was used to enroll 83 patients referred to Bou Ali Sina hospital, Qazvin, Iran, for permanent pacemaker device implantation during December 2010 to May 2012. The procedure was conducted by an electrophisiologist. Data such as ST-segment elevation and device parameters (threshold, sense, and impedance) were collected via recording during active implantation of device and analyzed using SPSS software.
Findings: Patient's mean age was 71.7 ± 1.4 years; 48.1% were men and 51.8% were women. Single chamber device was implanted for 25 cases and dual chamber device for 58 others. The mean ST-segment elevation was 3.95 ± 1.27 and 16.71 ± 3.41 mv in atrial and ventricular leads, respectively. The changes in other parameters separately in the atrial and ventricular leads were obtained and compared considering ST-segment changes. ST changes in the right atrium were correlated with sense and threshold (P = 0.003).
Since we could not find significant correlation between pacemaker parameters and ST elevation, it can be concluded that ST elevation during lead implantation is not a predictor for device performance.