TY - JOUR
T1 - Clinical and procedural outcome of patients implanted with a quadripolar left ventricular lead
T2 - Early results of a prospective multicenter study
AU - Forleo, Giovanni B.
AU - Mantica, Massimo
AU - Di Biase, Luigi
AU - Panattoni, Germana
AU - Della Rocca, Domenico G.
AU - Papavasileiou, Lida P.
AU - Santamaria, Matteo
AU - Santangeli, Pasquale
AU - Avella, Andrea
AU - Sergi, Domenico
AU - Santini, Luca
AU - Tondo, Claudio
AU - Natale, Andrea
AU - Romeo, Francesco
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2012/11
Y1 - 2012/11
N2 - Background: Recent studies suggest that cardiac resynchronization therapy (CRT) with a quadripolar left ventricular (LV) lead results in low rates of dislocation and phrenic nerve stimulation (PNS) acutely and at short-term follow-up. Confirmation of these results by long-term observational studies is needed. Objective: To evaluate the long-term procedural and clinical outcomes of CRT patients implanted with a quadripolar LV lead. Methods: A total of 154 consecutive heart failure patients (79% men, age 68 ± 10 years) having CRT implantation attempts with a quadripolar LV lead were included in this observational registry. Demographic and clinical data were preoperatively collected, and patients were followed up for at least 6 months. Results: The overall implant success rate after coronary sinus cannulation was 97.4%. Mean overall duration and fluoroscopy time of successful procedures was 112 ± 22 and 16 ± 8 minutes, respectively, while 17 ± 13 minutes were necessary for the LV lead placement. After implant, the conventional bipolar configuration was used as the final pacing configuration in 33.3% of the patients. Four lead dislodgments (requiring reoperation) and 9 clinical PNS were reported during follow-up; reprogramming of the device was sufficient to prevent PNS in all patients. Once placed, the LV lead remained stable with excellent pacing thresholds during follow-up (15 ± 5 months). Overall, there were 71.3% CRT responders as assessed by 6-month echocardiography, and 66% improved at least 1 New York Heart Association class. Conclusion: Over the longer term, CRT with the quadripolar LV lead is associated with excellent pacing thresholds, low rates of dislocations, and PNS.
AB - Background: Recent studies suggest that cardiac resynchronization therapy (CRT) with a quadripolar left ventricular (LV) lead results in low rates of dislocation and phrenic nerve stimulation (PNS) acutely and at short-term follow-up. Confirmation of these results by long-term observational studies is needed. Objective: To evaluate the long-term procedural and clinical outcomes of CRT patients implanted with a quadripolar LV lead. Methods: A total of 154 consecutive heart failure patients (79% men, age 68 ± 10 years) having CRT implantation attempts with a quadripolar LV lead were included in this observational registry. Demographic and clinical data were preoperatively collected, and patients were followed up for at least 6 months. Results: The overall implant success rate after coronary sinus cannulation was 97.4%. Mean overall duration and fluoroscopy time of successful procedures was 112 ± 22 and 16 ± 8 minutes, respectively, while 17 ± 13 minutes were necessary for the LV lead placement. After implant, the conventional bipolar configuration was used as the final pacing configuration in 33.3% of the patients. Four lead dislodgments (requiring reoperation) and 9 clinical PNS were reported during follow-up; reprogramming of the device was sufficient to prevent PNS in all patients. Once placed, the LV lead remained stable with excellent pacing thresholds during follow-up (15 ± 5 months). Overall, there were 71.3% CRT responders as assessed by 6-month echocardiography, and 66% improved at least 1 New York Heart Association class. Conclusion: Over the longer term, CRT with the quadripolar LV lead is associated with excellent pacing thresholds, low rates of dislocations, and PNS.
KW - Cardiac resynchronization therapy
KW - Multiple pacing configurations
KW - Phrenic nerve stimulation
KW - Quadripolar left ventricular lead
KW - Survey
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U2 - 10.1016/j.hrthm.2012.07.021
DO - 10.1016/j.hrthm.2012.07.021
M3 - Article
C2 - 22841876
AN - SCOPUS:84867883078
SN - 1547-5271
VL - 9
SP - 1822-1828.e3
JO - Heart Rhythm
JF - Heart Rhythm
IS - 11
ER -