Technical Improvements to be Achieved by the Year 2000: Leads and Connector Technology

Abstract

During the past 35 years, many technological advantages have been made in cardiac pacemaker leads and in the pulse generator-to-lead connector. Advances have included development of: various coiled wire conductors [1]; new fixation means such as tines, fins, and helix mechanisms [1,2]; advances in electrodes such as microporous surfaced electrodes, small surface area electrodes, electrodes with special shapes which enhance electrical fields and tissue ingrowth and steroid eluting electrodes [3, 4]; improved insultion such as “high-performance” or “extra tear-resistant” silicone rubbers, and various polyurethanes [5]; and improved, standardized connectors such as the recent “VS-1” and proposed “IS-1” standard connector designs [6]. These advances have improved the performance, reliability, and the ease of implantation of pacemaker leads and pulse generators dramatically. Perhaps however, historically, one of the most significant advances in pacemaking was the development of the transvenous pacemaker lead which made the therapy of cardiac pacing a relatively safe and easy procedure for virtually all patients [7].