Handbook of Leads for Pacing, Defibrillation & Cardiac Resynchronization, 3rd edition

Cuvillier. Cover 3rd edition.jpg
Cuvillier. Cover 3rd edition.jpg

Handbook of Leads for Pacing, Defibrillation & Cardiac Resynchronization, 3rd edition


New 3rd edition!

By: Erick Cuvillier, MSc
Foreword by: Blandine Mondesert, MD
Introduction by: Roger Carrillo, MD

Publisher: Erick Cuvillier
Publication Date: August 2016
ISBN: 9781618877840
Hardcover, 410 Pages

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This concise and clearly written 3rd edition handbook covers all aspects of cardiac leads for pacing, defibrillation, and cardiac resynchronization therapy. A useful and thorough guide for implanters, it is also an asset to anyone either entering in the field of devices or preparing for an examination.

A complete history of cardiac lead development from its beginning in the late 1950s to its status today. This comprehensive publication:

  • Presents basic principles of cardiac pacing
  • Defines essential lead structure, terminology, and technology
  • Clarifies complete aspects of lead engineering, design, function and reliability
  • Describes implant dynamics and practical aspects of in vivo conditions
  • Includes important updates and incorporates today’s technical and scientific developments
  • Serves as an excellent review to stay on the edge of this rapidly advancing field
  • Features over 1,200 drawings, pictures, illustrations and tables, most in full color

Table of Contents:


1.) Historical Milestones
Electrical stimulation
Cardiac pacing
Cardiac defibrillation
Cardiac resynchronization therapy (CRT)

2.) Cardiovascular System, Cardiac Rhythm and Cardiac Disorders
The heart
Cardiac function
Electrical conduction system
Heart beat anatomy
Heart rhythm disorders
Heart failure (HF)

3.) Pacing Leads
Description of an implantable pacemaker system
Evolution of pacemaker technology
Construction and components
Lead stiffness
Single-pass VDD lead
Biatrial pacing lead
Length and diameter

4.) Tachy Leads
Description of an implantable cardioverter defibrillator system
Evolution of technology - ICDs and leads
Construction and components
Shocking circuits
Coil electrode
Single-pass VDD ICD lead

5.) CRT Leads and Delivery Systems
Description of an implantable biventricular pacing system
Construction, components and programming options
Delivery systems
Lead fixation mechanisms
Over-the-wire (OTW)
Left ventricular endocardial pacing (LVEP)

6.) Epimyocardial Leads
The early days
Construction and components
Clinical applications
Special tools required for implants

7.) Temporary Pacing Leads
Transcutaneous, 170

8.) Electrode
Fixation mechanisms - the early days
Passive fixation mechanisms
Active fixation mechanisms
Materials and designs
Electrode-myocardium interface
Anti-inflammatory drugs, 189

9.) Conductor
Design and definition
Failure mechanisms

10.) Insulation
History of insulation materials
Fluoroethylene polymers
SI Polyimide
Degradation of insulation materials

11.) Connector
The early days
The need for standardization, the IS-1 connector
Connectors for high power leads and the DF-1 standard
Four-pole connector standards, the IS-4 and the DF-4

12.) Stylet and Guide Wire
Three-dimensional curve stylet
Stylet guide
Locking stylet
Guide wire
Hybrid guide wire

13.) Suture Sleeve
Design and clinical implications

14.) Accessories
Analyzer cable interface tool
Connector plug
Fixation tool
Guide wire steering handle
Lead pin cap
Medical adhesive kit
Vein lifter

15.) Lumenless Lead and Delivery System
The driving force for change
Definitions of pacing sites
Definitions of alternative pacing sites
Lead and delivery system

16.) Fluorovisibility
Views and interpretations

17.) Lead Performance
Classification of medical devices and regulatory pathways
Class I medical devices
Class II medical devices
Class III medical devices
Concept of reliability
Reliability and performance
Tracking and monitoring
Bench testing guidance
Manufacturer and User Facility Device Experiences (MAUDE) database

18.) Lead Extraction
Indications for transvenous lead extraction
Chronic pain
Thrombosis or venous stenosis
Functional leads
Non-functional leads
Fibrous encapsulation
Elements and technical considerations prior to lead extraction
Description of tools and techniques for lead extraction
Weighted traction
Intravascular counter-traction
Locking stylet
Retriever tool
Laser-assisted extraction
Mechanical dilator sheath set

19.) Lessons Learned
Abandoned leads
Contact allergy
Electrocautery effect on lead insulation material
Endocarditis with lead infections
Erosion and infection
Incomplete contact between lead connector pin and device header
Lead dislodgement
Leads related cardiac perforation
Pacemaker-induced superior vena cava syndrome
Persistent left superior vena cava
Phrenic nerve stimulation in CRT
Subclavian vein obstruction
Tricuspid valve regurgitation
Twiddler’s syndrome

20.) Manufacturers – Background, Acquisitions and Mergers

21.) Guidelines for Implantation
Classification of recommendations
Levels of evidence

22.) Magnetic Resonance Imaging (MRI)
Basic concept and description of MRI equipment
Patient safety and system classification
Current state of technology

23.) Sensors Integrated in Pacing Leads
Cardiac pressure sensor
Mixed venous oxygen saturation sensor
Central venous blood temperature sensor
Minute ventilation sensor
Cardiac muscle vibrations sensor
Left atrial pressure sensor

24.) Forces, Flexing and Other Implant Dynamics Leads Experience
In Vivo
Interaction of factors
Design and material considerations
Lead mechanics and patient anatomy
Classification of in vivo environments
Pocket, skeleto-muscular region and venous entry point
Vascular and intracardiac
Electrode-tissue interface
Coronary sinus

25.) Leadless Pacing
Review of concept
Reasoning for leadless pacing
Current state of technology
Suggested Readings