The electrode-tissue interface: the revolutionary role of steroid-elution
Abstract
The electrode‐tissue interface is that area lying between the cathode of a low‐voltage implantable pacemaker or cardioverter‐defibrillator (ICD) lead and the endocardium or epi‐myocardium of the cardiac chamber being paced. The electrical stimulus that is delivered to this interface is responsible for myocyte depolarization with consequent cardiac contraction. The process by which this occurs is reasonably well understood and any explanation requires a basic understanding of the physics and cellular electrophysiology of pacing. The effective and efficient delivery of electrical energy to the myocardium via the lead is dependent on many factors to be discussed in this review. However, despite numerous evolutionary changes occurring in the cathode's material, design, and surface configuration, it was not until the incorporation of steroid‐elution to the electrode‐tissue interface that reliable and significantly low stimulation threshold cardiac pacing became possible.
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Dexamethasone has found great success in pacemaker stimulator implants used in the clinic, where it is incorporated into the material surrounding the electrodes and elutes over time to hamper FBR and improve implant life-time and stability.
“Dexamethasone—a commonly used anti-inflammatory corticosteroid drug—has found great success in pacemaker stimulator implants used in the clinic, where it is incorporated into the material surrounding the electrodes and elutes over time into the surrounding tissue to hamper FBR and improve implant life-time and stability (Mond et al., 2014).”
From Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics (2021) · cites this paper as Mond et al., 2014
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- Authors
- MOND, H. G., HELLAND, J. R., STOKES, K., BORNZIN, G. A., & McVENES, R.
- Affiliations
- The Royal Melbourne Hospital (AU)
- St. Jude Medical Implantable Electronic Systems Division (IESD) Sylmar California
- (retired) Brainerd Minnesota
- Medtronic (United States) (US)
- Corresponding author
- MOND, HARRY G.
- ORCID
- MOND, HARRY G.
- Venue
- Pacing and Clinical Electrophysiology
- Publisher
- Wiley
- Published
- 2014-07-29
- Volume
- 37
- Issue
- 9
- Pages
- 1232-1249
- ISSN
- 0147-8389 (ISSN-L)
- 1540-8159
- OpenAlex
- W3024398725
- Cited by
- 58
- References
- 69
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 7 · 2023: 2 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 1
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pacing and Clinical Electrophysiology (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Keywords
- electrode-tissue interface, steroid-eluting leads, cardiac pacing, implantable cardioverter-defibrillator leads, pacemaker leads, cardiac depolarization, cardiac electrophysiology
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