Abstract
BackgroundWe retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads (steroid eluting vs. non-steroid eluting) in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance.MethodsBetween March 2008 and May 2014 an epicardial LV lead was implanted in 32 patients after failed transvenous LV lead placement using a left-sided lateral minithoracotomy or video-assisted thoracoscopy (mean age 64 ± 9 years). Patients were divided into two groups according to the type of implanted lead. Steroid eluting (SE) group: 21 patients (Myodex™ 1084 T; St. Jude Medical) and non-steroid eluting (NSE) group: 11 patients (MyoPore® 511,212; Greatbatch Medical).ResultsAll epicardial leads could be placed successfully, without any intraoperative complications or mortality. With regard to the implanted lead following results were observed: sensing (mV): SE 8.8 ± 6.1 vs. NSE 10.1 ± 5.3 (p = 0.380); pacing threshold (V@0.5 ms): SE 1.0 ± 0.5 vs. NSE 0.9 ± 0.5 (p = 0.668); impedance (ohms): SE 687 ± 236 vs. NSE 790 ± 331 (p = 0.162). At the follow-up (2.6 ± 1.9 years) the following results were seen: sensing (mV): SE 8.7 ± 5.0 vs. NSE 11.2 ± 6.6 (p = 0.241), pacing threshold (V@0.5 ms): SE 1.4 ± 0.5 vs. NSE 1.0 ± 0.3 (p = 0.035), impedance (ohms): SE 381 ± 95 vs. NSE 434 ± 88 (p = 0.129).ConclusionsBased on the results no strong differences have been found between the both types of epicardial LV leads (steroid eluting vs. non-steroid eluting) in CRT implantation in short- and midterm.
Highlights
We retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance
Based on the results no strong differences have been found between the both types of epicardial LV leads in CRT implantation in short- and midterm
Study population and clinical data We identified and retrospectively evaluated 32 consecutive patients who underwent sutureless epicardial left ventricular lead implantation either via left lateral minithoracotomy, or video-assisted thoracoscopy at our institution between March 2008 and May 2014
Summary
We retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads (steroid eluting vs. non-steroid eluting) in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance. Despite the advances in the optimal medical treatment, strategies and therapies for medically refractory symptomatic advanced heart failure have emerged, including cardiac resynchronization therapy. In patients undergoing cardiac interventions with open chest surgery and present indication for CRT, the implantation of the left ventricular lead can be performed epicardially. Despite few comparative studies on the different surgical LV leads, little is known about the short- and longterm performance of the different sutureless epicardial lead types. The aim of the study was to investigate the differences between two types of sutureless screw-in LV leads (steroid eluting vs non-steroid eluting) in CRT implantation with regards to the electrical performance on the short- and mid-term
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