Cardiac resynchronization therapy: Femoral approach

Brandão, Luis Felipe; Miranda, Rita; Almeida, Sofia; Ribeiro, Luciano Paes Landim; Alvarenga, Carlos José Souza de; João, Isabel; Pereira, Hélder

doi:10.1016/j.repc.2016.07.015

Cited by 4 publications

(1 citation statement)

References 2 publications

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“… 6 , 7 , 8 , 9 , 10 , 11 However, the experience of complex pacing devices (ICD and CRT) is limited to a small number of case reports with short follow‐up duration (Table 1 ). 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 Acute implantation success, longer term follow‐up of complex femoral devices, the necessity for subsequent procedures, and the feasibility and safety of chronic complex femoral device extraction has not been reported.…”

Section: Introductionmentioning

confidence: 99%

The long‐term outcomes of cardiac implantable electronic devices implanted via the femoral route

Griffiths

Behar

Kramer

et al. 2022

Pacing Clinical Electrophis

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Background: Conventional superior access for cardiac implantable electronic devices (CIEDs) is not always possible and femoral CIEDs (F-CIED) are an alternative option when leadless systems are not suitable. The long-term outcomes and extraction experiences with F-CIEDs, in particular complex F-CIED (ICD/CRT devices), remain poorly understood.Methods: Patients referred for F-CIEDs implantation between 2002 and 2019 at two tertiary centers were included. Early complications were defined as ≤30 days following implant and late complications >30 days.Results: Thirty-one patients (66% male; age 56 ± 20 years; 35% [11] patients with congenital heart disease) were implanted with F-CIEDs (10 ICD/CRT and 21 pacemakers).Early complications were observed in 6.5% of patients: two lead displacements. Late complications at 6.8 ± 4.4 years occurred in 29.0% of patients. This was higher with complex F-CIED compared to simple F-CIED (60.0% vs. 14.3%, p = .02). Late complications were predominantly generator site related (n = 8, 25.8%) including seven infections/erosions and one generator migration. Eight femoral generators and 14 leads (median duration in situ seven [range 6-11] years) were extracted without complication.Conclusions: Procedural success with F-CIEDs is high with clinically acceptable early complication rates. There is a notable risk of late complications, particularly involving the generator site of complex devices following repeat femoral procedures. Extraction of chronic F-CIED in experienced centers is feasible and safe.

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