Left Ventricular Lead Performance in Cardiac Resynchronization Therapy: Impact of Lead Localization and Complications

Albertsen, Andi Eie; Nielsen, Jens Cosedis; Pedersen, Anders Kirstein; Hansen, Peter S.; Jensen, Henrik Kjærulf; Mortensen, Peter Thomas

doi:10.1111/j.1540-8159.2005.40066.x

Cited by 71 publications

(39 citation statements)

References 16 publications

(46 reference statements)

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“…Target veins were lateral or posterolateral veins. The LV lead position was determined using biplane fluoroscopy classification (22). In the right anterior oblique view and/or in the postero-anterior view, the distance between the coronary sinus/mitral plane and the cardiac apex was divided in 3 parts and the LV lead position was classified in 3 groups: basal, midventricular, and apical.…”

Section: Study Population and Protocolmentioning

confidence: 99%

Effects of Cardiac Resynchronization Therapy on Left Ventricular Twist

Bertini

Marsan

Delgado

et al. 2009

Journal of the American College of Cardiology

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Section: Study Population and Protocolmentioning

confidence: 99%

Effects of Cardiac Resynchronization Therapy on Left Ventricular Twist

Bertini

Marsan

Delgado

et al. 2009

Journal of the American College of Cardiology

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“…This topographic assessment was chosen after previous observations that clinical response to CRT is maximal when LV lead placement around the 3 o'clock position in the LAO view is achieved. 8 Differently from Albertsen et al, 8 we divided the LV into 2 sites according to the variability of the left phrenic nerve course, as observed by Quintana et al, 9 which could yield different PS prevalence in very close LV sites.…”

Section: Lead Positionmentioning

confidence: 99%

Phrenic Stimulation

Biffi

Moschini

Bertini

et al. 2009

Circ: Arrhythmia and Electrophysiology

115

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Background-Phrenic stimulation (PS) may hinder left ventricular (LV) pacing. We prospectively observed its prevalence in consecutive patients with cardiac resynchronization therapy (CRT) devices. Methods and Results-In the years 2003 to 2006, 197 patients received a CRT device. PS and LV threshold measurements were carried out at implantation and at 6-month follow-up. LV reverse remodeling was assessed by echocardiography before implantation and at follow-up. LV lead placement was lateral/posterolateral in 86% of patients. Both PS and LV reverse remodeling occurred most frequently at the lateral/posterolateral LV pacing sites (PϽ0.001). PS was detected in 73 (37%) of patients and was clinically relevant in 41 (22%). The detection of PS at implantation had a poor sensitivity, as it occurred only in left lateral or sitting position in 27 patients. Ten patients (5%) underwent repeated surgery and 4 (2%) had their CRT turned off because of PS. At follow-up, we could manage PS noninvasively in 32 patients with a small PS-LV threshold difference: in 20 by cathode programmability (3 also thanks to automatic management of LV output) and in 12 (without cathode programmability) by programming the LV output as threshold ϩ1 V. Conclusions-PS may seriously hinder CRT. A bipolar LV lead and cathode programmability are mandatory to avoid PS by changing the LV pacing vector at target sites for CRT. LV stability at target sites despite PS should also be pursued by these means. The automatic adjustment of LV pacing output is complementary in patients with a small PS-LV threshold difference. (Circ Arrhythmia Electrophysiol. 2009;2:402-410.)

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“…Ein postoperatives Auftreten einer NPS wird in der Literatur bei 4-9,2% der CRTPatienten beschrieben [1,4,16,17]. Bei 0,9-4,9% der CRTPatienten konn te die NPS nicht durch Umprogrammie rung behoben werden und erforderte eine Revisionsoperation [1,2,3,4,6,13,14,15,16].…”

Section: Patienten Und Methodenunclassified

“…Bei 0,9-4,9% der CRTPatienten konn te die NPS nicht durch Umprogrammie rung behoben werden und erforderte eine Revisionsoperation [1,2,3,4,6,13,14,15,16]. Wir verzeichneten an unserem Kran kengut 3 Revisionsoperationen bei 239 Pa tienten (=1,25%).…”

Section: Patienten Und Methodenunclassified