Acute and long-term outcomes of quadripolar IS-4 versus bipolar IS-1 left ventricular leads in cardiac resynchronization therapy: A retrospective registry study.

Autor: Maurhofer J; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Asatryan B; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Haeberlin A; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland., Noti F; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Roten L; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Seiler J; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Baldinger SH; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Franzeck F; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Lam A; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Kueffer T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Reichlin T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Tanner H; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Servatius H; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2023 May; Vol. 46 (5), pp. 365-375. Date of Electronic Publication: 2023 Apr 05.
DOI: 10.1111/pace.14686
Abstrakt: Background: The implantation procedure of left ventricular (LV) leads and the management of cardiac resynchronization therapy (CRT) patients can be challenging. The IS-4 standard for CRT offers additional pacing vectors compared to bipolar leads (IS-1). IS-4 leads improve procedural outcome and may also result in lower adverse events during follow-up (FU) and improve clinical outcome in CRT patients. Further long-term FU data comparing the two lead designs are necessary.
Methods: In this retrospective, single-center study we included adult patients implanted with a CRT-Defibrillator (CRT-D) or CRT-Pacemaker (CRT-P) with a quadripolar (IS-4 group) or bipolar (IS-1 group) LV lead and with available ≥3 years clinical FU. The combined primary endpoint was a combination of predefined, lead-related adverse events. Secondary endpoints were all single components of the primary endpoint.
Results: Overall, 133 patients (IS-4 n = 66; IS-1 n = 67) with a mean FU of 4.03 ± 1.93 years were included. Lead-related adverse events were less frequent in patients with an IS-4 lead than with an IS-1 lead (n = 8, 12.1% vs. n = 23, 34.3%; p = .002). The secondary outcomes showed a lower rate of LV lead deactivation/explantation and LV lead dislodgement/dysfunction (4.5% vs. 22.4%; p = .003; 4.5% vs. 17.9%; p = .015, respectively) in the IS-4 patient group. Less patients suffered from unresolved phrenic nerve stimulation with an IS-4 lead (3.0% vs. 13.4%; p = .029). LV lead-related re-interventions were fewer in case of an IS-4 lead (6.1% vs. 17.9%; p = .036).
Conclusion: In this retrospective analysis, the IS-4 LV lead is associated with lower lead-related complication rates than the IS-1 lead at long-term FU.
(© 2023 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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