Prediction of Midterm Performance of Active‐Fixation Leads Using Current of Injury

Haghjoo, Majid; Mollazadeh, Reza; Aslani, Amir; Dastmalchi, Jalal; Mashreghi-Moghadam, Hamidreza; Heidari-Mokarar, Hadi; Vakili-Zarch, Anoushiravan; Alizadeh, Abolfath

doi:10.1111/pace.12262

Cited by 12 publications

(11 citation statements)

References 13 publications

(18 reference statements)

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“…Fixation of leads into myocardial tissue during cardiac device implantation results in acute tissue injury also known as current of injury (COI) and is recognized by an elevation of the ST‐segment compared with baseline and an increase in the duration of the intracardiac electrogram (EGM) 1 . Several studies have demonstrated that the presence of a COI is associated with better acute performance and long‐term stability with active fixation leads 1–6 . Vijayaraman et al 3 reported the presence of His bundle COI with leads implanted at the His bundle.…”

Section: Introductionmentioning

confidence: 99%

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Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Cai

et al. 2020

Cardiovasc electrophysiol

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Background Left bundle branch pacing (LBBP) is emerging as a novel option for physiological ventricular pacing. The impact of current of injury (COI) at left bundle branch (LBB) has not been previously evaluated. Methods Consecutive patients with QRS duration less than 120 milliseconds referred for LBBP in whom LBB potentials were recorded were included from August 2018 to March 2019. We recorded LBB COI during LBBP and assessed its impact on the pacing parameters and complications during implantation and at short term follow‐up. Results A total of 115 patients with an identifiable LBB potential at implant were included. LBB COI was confirmed in 77 (67.0%) of these patients. Three types of LBB COI were observed. LBB was captured in all patients at a pacing threshold less than 1.5 V/0.5 ms in COI(+) patients, while present in only 29 patients without an LBB COI(−) (100% vs 76.3%; P < .001). There was no significant difference between COI(+) and COI(−) patients in LBB bundle capture threshold (0.64 ± 0.24 vs 0.74 ± 0.26 V/0.5 ms). Selective LBBP was more common in COI(+) group than COI(−) group (54.5% vs 0%; P < .001). Pacing parameters were stable and no lead perforation or dislodgements were observed during follow‐up. Conclusions LBB COI is commonly observed during LBBP in cases with an identifiable LBB potential and can be associated with a low LBB capture threshold and demonstrable selective capture of the LBB acutely and during follow‐up. A COI does not preclude safe and stable LBBP pacing.

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Section: Introductionmentioning

confidence: 99%

“…performance and long-term stability with active fixation leads. [1][2][3][4][5][6] Vijayaraman et al 3 reported the presence of His bundle COI with leads implanted at the His bundle. His bundle COI was noted in 37% of cases undergoing His bundle pacing (HBP) and was associated with a low pacing threshold.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Cai

et al. 2020

Cardiovasc electrophysiol

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“…Overall, patients have accepted ICDs as life sustaining technology, and they are widely used worldwide ( 6 ). The first ICD was used in 1980 ( 7 ), and in Iran, the history of this device goes back to 1995 ( 8 ). Although an ICD is much more effective than other treatments in controlling dysrhythmias and heart diseases ( 9 ), living with an ICD is accompanied with challenges for both the patients and their families ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

The Challenges of Living With an Implantable Cardioverter Defibrillator: A Qualitative Study

Abbasi

Negarandeh

Norouzadeh

et al. 2016

Iran Red Crescent Med J

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BackgroundDysrhythmia is one of the most common causes of sudden cardiac death worldwide. An implantable cardioverter defibrillator is the most effective method of treatment for dysrhythmias causing cardiac arrest. However, living with an implantable cardioverter defibrillator is associated with challenges such as fear, anxiety, and depression.ObjectivesThe purpose of this study was to identify the challenges of living with an implantable cardioverter defibrillator.Patients and MethodsIn this qualitative study, an interpretive phenomenological approach was used, with thirteen participants (seven men and six women) between the ages of 21 and 70 years old (mean = 58.15, SD = 14.4). The duration of having an implantable cardioverter defibrillator was 1 - 120 months (mean = 23.15, SD = 33.31). Maximum variation sampling was used to purposefully select the participants from the governmental Imam Khomeini hospital in Tehran, Iran, between May and October of 2013. Semi-structured interviews were conducted for 30 to 45 minutes, and Van Manen’s six-step method was used in this study.ResultsThe challenges of living with an implantable cardioverter defibrillator include: living with fear, concerns about the future, concerns about device malfunction, fearing death during the shock, pain due to the shock, loss of control, the cost of the device, and the lifestyle limitations.ConclusionsPatients who live with implantable cardioverter defibrillators face many concerns and challenges. Therefore, the role of nurses in teaching patients before and after implementation is very important.

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“…In addition, Haghjoo et al. reported that the mid‐term performance of active fixation leads could be estimated by the ST‐segment elevation at the time of fixation . Both atrial and ventricle leads with good performance exhibited a higher ST‐segment elevation at the time of fixation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the current of injury in envisaging the dislodgement of leads implanted in the right atrial septum or the right ventricular septum

Yoshiyama

Shimeno

Matsuo

et al. 2019

Pacing Clinical Electrophis

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Background The implantation of leads in the right atrial septum (RAS) or the right ventricular septum (RVS) is technically challenging, and dislodgement occurs occasionally. This study aims to determine a predictor for the dislodgement of leads implanted in the RAS or RVS. Methods This retrospective cohort study enrolled 137 consecutive patients who underwent the cardiac implantable electronic devices implantation, using active fixation leads in the RAS and RVS. We compared the pacing threshold, R‐ or P‐wave amplitude, slew rate, and presence of the current of injury (COI) between dislodged and nondislodged leads. Results We performed lead fixation for 74 and 125 times in the RAS and RVS, respectively. Atrial lead dislodgement occurred five times (6.8%) intraoperatively and five times (6.8%) postoperatively, whereas ventricular lead dislodgement occurred eight times (6.4%) intraoperatively and three times (2.4%) postoperatively. Although there were no lead parameters that showed a significant difference common to RAS lead and RVS lead, the presence of the COI was significantly different between nondislodged and dislodged leads in both the RAS and RVS (atrial leads: 57.8% vs 0%, P < 0.001; ventricular leads: 67.5% vs 9.1%, P < 0.001). The positive predictive value of COI presence for predicting no lead dislodgement was 100% and 98.7% in the RAS and RVS, respectively. Conclusion Lead dislodgement is more likely when the COI is absent; documentation of COI should be pursued during lead implantation in challenging sites as the RAS and RVS.

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Prediction of Midterm Performance of Active‐Fixation Leads Using Current of Injury

Abstract: Midterm performance of active-fixation leads is predictable using COI recorded at the time of lead implantation. A ST-segment elevation ≥2.0 mV in the atrial leads and ≥10.0 mV in the ventricular leads are recommended to improve the lead performance at 6 months.

Cited by 12 publications

References 13 publications

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

The Challenges of Living With an Implantable Cardioverter Defibrillator: A Qualitative Study

Efficacy of the current of injury in envisaging the dislodgement of leads implanted in the right atrial septum or the right ventricular septum

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