Importance of Knowing Lead and Patient Interaction

  • Raffaele De Lucia
  • Giovanni Coluccia
  • Stefano Viani
  • Luca Paperini


The implantable cardiac pacemaker (PM)/defibrillator is a technically sophisticated system composed of a generator connected to one or more leads. Pacemaker/defibrillator leads play a pivotal role for system function, delivering the output pulse or the endocardial shock from the generator to the myocardium and acquiring spontaneous intracardiac electrogram from the heart to the device. Leads are also the most frequently involved component in case of system malfunction, and when a generator-pocket infection is present, their extraction — always necessary to guarantee complete resolution — is a challenge. The success of lead extraction is highly influenced by lead characteristics; for that reason, this chapter is dedicated to lead technology, i.e., polarity, electrodes, fixation mechanisms, electrode-tissue interaction, conductors, insulators, and connectors, with particular attention to aspects that may interfere with the extraction procedure. We discuss separately cardiac PM and defibrillator leads to emphasize their different technology.


Silicone Rubber Superior Vena Cava Subclavian Vein Venous Obstruction Pace Lead 
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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • Raffaele De Lucia
    • 1
  • Giovanni Coluccia
    • 1
  • Stefano Viani
    • 1
  • Luca Paperini
    • 1
  1. 1.2nd Cardiovascular Department AOUPSanta Chiara University HospitalPisaItaly

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