Cardiac implantable electronic devices in patients with persistent left superior vena cava-A single center experience.

Autor: Ghazzal B; Department of Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon., Sabayon D; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia., Kiani S; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Leon AR; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Delurgio D; Division of Cardiac Electrophysiology, Emory University, Atlanta, Georgia., Patel AM; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Lloyd MS; Division of Cardiovascular Electrophysiology, Emory University, Atlanta, Georgia., Westerman S; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Shah A; Division of Cardiovascular Electrophysiology, Emory University, Atlanta, Georgia., Merchant FM; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., El-Chami MF; Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2020 May; Vol. 31 (5), pp. 1175-1181. Date of Electronic Publication: 2020 Apr 08.
DOI: 10.1111/jce.14460
Abstrakt: Background: There are limited data on cardiac implantable electronic device implantation (CIED) in patients with persistent left superior vena cava (PLSVC).
Objective: To describe the outcomes of implanting CIEDs with a focus on cardiac resynchronization therapy (CRT) in patients with PLSVC.
Methods: We identified all patients with a PLSVC that underwent CIED implantation from December 2008 until February 2019 at our institution by querying the electronic medical record (n = 34). We then identified controls in a 3:1 fashion (n = 102) by matching on device type (CRT vs non-CRT). Procedure success, complications, fluoroscopy and procedural time were recorded. Outcomes were compared using a two-way analysis of variance test and conditional regression modeling for continuous and categorical variables, respectively.
Results: A total of 34 patients with PLSVC underwent 38 procedures. Four patients underwent dual chamber system implantation followed by a subsequent upgrade to CRT. Thirteen patients underwent CRT implantation: one was implanted via the right subclavian while the rest were implanted via the PLSVC. Left ventricular (P = .06). Procedure and fluoroscopy times were significantly higher in the PLSVC as compared with the control group (97.7 vs 66.1 minute, P < .001 and 18.1 minute vs 8.7 minutes, P = .005, respectively).
Conclusion: CIED implant in patients with PLSVC is feasible but technically more challenging and appears to be associated with higher risk of right ventricular lead dislodgment.
(© 2020 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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