Pacing lead with porous electrode for stable low threshold high impedance pacing

摘要

A pacing lead, and system for pacing, where the lead has an improved distal tip designed to provide reliable chronic fixation of the electrode- heart interface, while also providing low pacing threshold. The distal end of the lead has a standard surface, of roughly hemispherical shape, made of a porous material. In one embodiment, the tip surface is suitably about 6-8 square mm, and there is a smaller surface of about 1.5-2.0 square mm which is electrically isolated from the remainder of the porous surface; the smaller surface acts as a high impedance electrode, providing low threshold, while the larger porous surface provides the stable fixation. A steroid source is housed in the distal end of the lead, so as to provide an eluted steroid to the electrode surface area, as well as at least part of the remaining porous surface, whereby the overall porous surface and the eluted steroid minimizes the resulting capsule of non-excitable tissue around the electrode, providing for a stable reduced threshold. In another embodiment, a switching network is provided, suitably in the pacemaker, for selectively connecting one or both portions as the active electrode for pacing and for sensing.