Effect of lead locali̇zation after cardi̇ac pacemaker and icd implantation: change in impedance, sense and threshold values at minimum 12 hours and after analysis

Worldwide and in our country, the use of pacemakers is rapidly increasing, which indicates a significant rise in the number of patients treated with these devices. Technological advancements have enabled a diversification and increase in the number of clinical studies related to pacemakers. Pacemakers are categorized into two main groups: conventional pacemakers and implantable cardioverter defibrillators (ICDs), used for the treatment of various cardiac rhythm disorders. Both devices are designed to be externally programmable after implantation, allowing their parameters to be adjusted as needed to provide the most appropriate treatment for the patient's heart. Patients with pacemakers must undergo regular check-ups before the battery life expires. During these check-ups, the device's performance is evaluated using specific parameters and changes in arrhythmia conditions, and additional tests are conducted if necessary. Our study includes a total of 50 patients who received pacemaker implants, 37 of whom were implanted with pacemakers and 13 with ICDs. These devices were newly implanted in the angiography laboratory, and after dressing was completed, their function was evaluated using a programming device. During these evaluations, lead impedance, sensing, and threshold values were tested three times, and the data were recorded. The measurements were repeated 12 hours later, and the results were compared. The test outcomes were analyzed separately for pacemaker and ICD devices, considering the lead localizations. The findings demonstrate a statistically significant and anticipated decrease in lead impedance across all atrial and ventricular placements. In contrast, no statistically significant changes were observed in sensing and threshold values, which remained stable throughout. In conclusion, this study confirms that the expected reductions in lead impedance occur within the short term following pacemaker implantation, while sensing and threshold values exhibit a high degree of stability. These results strongly support the clinical efficacy and reliability of the modern devices utilized.