A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes

Mohit K. Turagam, Muhammad R. Afzal, Sandia Iskander, Madhu Reddy, Luigi Di Biase, Andrea Natale, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: We aimed to perform a meta-analysis from eligible studies to analyze the true impact of QL when compared with BL with regard to post-procedural outcomes including lead deactivation, revision or replacement. Background: Many observational and retrospective studies showed that quadripolar left ventricular leads (QL) are associated with better outcomes and fewer complications when compared with bipolar leads (BL). Methods: We performed a comprehensive literature search through June 30, 2015 using: quadripolar, bipolar, left ventricular lead and CRT in Pubmed, Ebsco and google scholar databases. Results: The analysis included 8 studies comparing QL and BL implantation. Post-procedural outcomes such as lead deactivation, revision or replacement were used as primary outcome and assessed with Mantel-Haenszel risk ratio (RR). Secondary outcomes included total fluoroscopy/procedure time, occurrence of phrenic nerve stimulation (PNS) and all-cause mortality on follow up. Follow-up duration for the studies ranged from 3 to 60 months. Compared with BL, the use of QL is associated with 52 % reduction (relative risk 0.48; 95% CI: 0.36-0.64, p=0.00001) in the risk of deactivation, revision or replacement of the LV lead. QL had significantly lower fluoroscopy/procedure time, PNS and all-cause mortality when compared with BL. Conclusion: Our meta-analysis shows that QL implantation was associated with decreased risk of LV lead deactivation, revision or replacement when compared with BL.

Original languageEnglish (US)
Pages (from-to)7-11
Number of pages5
JournalJournal of Atrial Fibrillation
Volume9
Issue number2
StatePublished - Aug 1 2016

Fingerprint

Meta-Analysis
Phrenic Nerve
Fluoroscopy
Mortality
PubMed
Observational Studies
Retrospective Studies
Odds Ratio
Lead
Databases

Keywords

  • Bipolar lead
  • Cardiac resynchronization therapy
  • Congestive heart failure
  • Meta-analysis
  • Quadripolar lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Turagam, M. K., Afzal, M. R., Iskander, S., Reddy, M., Di Biase, L., Natale, A., & Lakkireddy, D. (2016). A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes. Journal of Atrial Fibrillation, 9(2), 7-11.

A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes. / Turagam, Mohit K.; Afzal, Muhammad R.; Iskander, Sandia; Reddy, Madhu; Di Biase, Luigi; Natale, Andrea; Lakkireddy, Dhanunjaya.

In: Journal of Atrial Fibrillation, Vol. 9, No. 2, 01.08.2016, p. 7-11.

Research output: Contribution to journalArticle

Turagam, MK, Afzal, MR, Iskander, S, Reddy, M, Di Biase, L, Natale, A & Lakkireddy, D 2016, 'A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes', Journal of Atrial Fibrillation, vol. 9, no. 2, pp. 7-11.
Turagam, Mohit K. ; Afzal, Muhammad R. ; Iskander, Sandia ; Reddy, Madhu ; Di Biase, Luigi ; Natale, Andrea ; Lakkireddy, Dhanunjaya. / A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes. In: Journal of Atrial Fibrillation. 2016 ; Vol. 9, No. 2. pp. 7-11.
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