Implantation of cardiac resynchronization therapy systems in the CARE-HF trial: procedural success rate and safety

Gras, Daniel; Böcker, Dirk; Lunati, Maurizio; Wellens, Hein J.J.; Calvert, Melanie; Freemantle, Nick; Gervais, Renaud; Kappenberger, Lukas; Tavazzi, Luigi; Erdmann, Erland; Cleland, John G.F.; Daubert, Jean‐Claude

doi:10.1093/europace/eum080

Cited by 157 publications

(113 citation statements)

References 24 publications

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“…With the dramatic increase in the number of ICD implantations, 6 it is important to understand complications related to implantation. Data regarding implantation-related adverse events from rhythmmanagement devices, both pacemakers [7][8][9][10][11] and ICDs, [12][13][14][15] are limited because they are derived from clinical trials, singlecenter reports, or studies using administrative data. Clinical trials of procedures generally include experienced centers and highly selected patient populations.…”

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confidence: 99%

Gender Differences in Procedure-Related Adverse Events in Patients Receiving Implantable Cardioverter-Defibrillator Therapy

et al. 2009

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were male, and 27% were female. Women were more likely to have a history of heart failure (81% versus 77%, PϽ0.01), worse New York Heart Association functional status (57% versus 50% in class III and IV, PϽ0.01), and nonischemic cardiomyopathy (44% versus 27%, PϽ0.01) and were more likely to receive biventricular ICDs (39% versus 34%, PϽ0.01). In unadjusted analyses, women were more likely to experience any adverse event (4.4% versus 3.3%, PϽ0.001) and major adverse events (2.0% versus 1.1%, PϽ0.001). In multivariable models, women had a significantly higher risk of any adverse event (OR 1.32, 95% CI 1.24 to 1.39) and major adverse events (OR 1.71, 95% CI 1.57 to 1.86). Conclusions-Women are more likely than men to have in-hospital adverse events related to ICD implantation. Efforts are needed to understand the reasons for higher ICD implantation-related adverse event rates in women and to develop strategies to reduce the risk of these events.

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confidence: 99%

Gender Differences in Procedure-Related Adverse Events in Patients Receiving Implantable Cardioverter-Defibrillator Therapy

et al. 2009

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“…Coronary sinus (CS) lead implantation for cardiac resynchronization therapy (CRT) is associated with a signifi cant rate of lead dislodgment [1,2]. The use of a lead with an activefi xation mechanism (e.g.…”

Section: Introductionmentioning

confidence: 99%

Extraction of an Infected Active Fixation Coronary Sinus Lead with the Aid of a Tissue Stabilizer

Bortolotti¹

2017

J Cardiovasc Med Cardiol

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We present a 49-year-old man who required extraction of a cardiac resynchronization device due to lead infection. While 2 leads were successfully retrieved by a transvenous approach the third one with active fi xation and entrapped into a coronary sinus side-branch, required surgical intervention. During the operation, performed on cardiopulmonary bypass on a beating heart, lead extraction was greatly facilitated by employment of a tissue stabilizer routinely used for off-pump coronary surgery.

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“…The standard approach indicates the necessity for the implantation of an LV pacing lead transvenously into one of the tributary veins of the coronary sinus (CS). However, even with the improvement in dedicated devices and increased operator experience, failure to implant a CS lead has been reported in 4-8% of the cases [4,5]. Unfavorable CS or vein anatomy, such as CS dissection, occlusion, or abnormal ostium of the CS or focal coronary vein stenosis are the most frequent reasons.…”

Section: Introductionmentioning

confidence: 99%

Transseptal Leftventricular Endocardial Pacing is an Alternative Technique in Cardiac Resynchronization Therapy. One Year Experience in a High Volume Center

Neuhoff

Szilágyi

Molnár

et al. 2016

Romanian Journal of Internal Medicine

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Introduction. In patients receiving cardiac resynchronization therapy (CRT), failure rate to implant the left ventricular (LV) lead by the traditional trans-venous approach is 4-8%. Surgical epicardial implantation is considered as an alternative, but this technique is not without morbidity. Evidence from case documentation and from small trial batches demonstrated the viability of endocardial LV lead implantation where surgical epicardial lead placement is not applicable.Material and Methods. Four patients were implanted with endocardial LV lead using the transseptal atrial approach after unsuccessful transvenous implantation. Implantation of an endocardial active fixation LV leads was successful in all patients with stable electrical parameters immediately after implantation and over the follow-up period. All patients received anticoagulation therapy in order to target the international normalized ratio of 2.5-3.5 and have not experienced any thromboembolic, hemorrhagic events, or infection.Results. Follow-up echocardiography indicated significant improvement of LV systolic function (24 + 4.9 to 32 + 5.1 %, P = 0.023) with a notable improvement of the functional status.Conclusions. Endocardial left ventricular lead implantation can be a valuable and safe alternative technique to enable LV stimulation in high surgical risk patients where standard coronary sinus implant is unsuccessful.

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Implantation of cardiac resynchronization therapy systems in the CARE-HF trial: procedural success rate and safety

Abstract: Transvenous CRT system implantation, using a CS lead designed for long-term LV pacing, was safe and reliable. As implanting centres become more experienced, this success rate is expected to increase further.

Cited by 157 publications

References 24 publications

Gender Differences in Procedure-Related Adverse Events in Patients Receiving Implantable Cardioverter-Defibrillator Therapy

Gender Differences in Procedure-Related Adverse Events in Patients Receiving Implantable Cardioverter-Defibrillator Therapy

Extraction of an Infected Active Fixation Coronary Sinus Lead with the Aid of a Tissue Stabilizer

Transseptal Leftventricular Endocardial Pacing is an Alternative Technique in Cardiac Resynchronization Therapy. One Year Experience in a High Volume Center

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