Improved reliability of postoperative cardiac facing by use of bipolar temporary pacing leads

The implantation of temporary epimyocardial pacing leads (EPL, heartwires) has become a routine procedure after completion of cardiac surgery. These leads are mainly used for the treatment of postoperative bradyarrhythmias or conduction abnormalities by external pacemakers. The purpose of the following study was to compare the reliability of unipolar versus bipolar temporary pacing leads. We used three types of commercially available leads: Osypka TME 66Z (bipolar), Biotronik MHW 60 BP (bipolar), Medtronic 6500 (unipolar). The study included 76 patients after cardiac surgery in whom the different leads were routinely implanted and measured daily over the first 10 postoperative days. Our results show significant (p<0.05) differences concerning postoperative atrial pacing and sensing parameters. We conclude that bipolar epimyocardial pacing leads should be routinely used especially in the atrium after cardiac surgery.