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 Â± 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 Â± 22 and 16 Â± 8 minutes, respectively, while 17 Â± 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 Â± 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.
Clinical and procedural outcome of patients implanted with a quadripolar left ventricular lead: Early results of a prospective multicenter study / G.B. Forleo, M. Mantica, L. Di Biase, G. Panattoni, D.G. Della Rocca, L.P. Papavasileiou, M. Santamaria, P. Santangeli, A. Avella, S.D. Sergi, L. Santini, C. Tondo, A..P.L. Natale, F. Romeo. - In: HEART RHYTHM. - ISSN 1547-5271. - 9:11(2012), pp. 1822-1828.
|Titolo:||Clinical and procedural outcome of patients implanted with a quadripolar left ventricular lead: Early results of a prospective multicenter study|
|Parole Chiave:||Cardiac resynchronization therapy; Multiple pacing configurations; Phrenic nerve stimulation; Quadripolar left ventricular lead; Survey; Aged; Chi-Square Distribution; Echocardiography; Equipment Failure; Female; Fluoroscopy; Heart Failure; Humans; Male; Prospective Studies; Registries; Statistics, Nonparametric; Surveys and Questionnaires; Treatment Outcome; Ventricular Dysfunction, Left; Cardiac Resynchronization Therapy Devices; Electrodes, Implanted; Cardiology and Cardiovascular Medicine; Physiology (medical)|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.hrthm.2012.07.021|
|Appare nelle tipologie:||01 - Articolo su periodico|