The Time to Elective Replacement of BV Implantable Defibrillators: Manufacturers are not Created Equal?

Abstract

Results: 159 CRT procedures in 139 patients were performed between 2000 and April 2011. Sixty-three percent were new device implants, 23% upgrade from standard pacemaker to CRT, 12% lead change or repositioning. Of new implants: median age 62yrs, 77% male, 34% ischaemic cardiomyopathy, 11% in atrial fibrillation, median LV ejection fraction 25% (interquartile range (IQR) 19-30%), 91% LBBB, median QRS duration 170 ms (IQR 160-200 ms), 49% received CRT with defibrillator. Median procedure time was 140 min (IQR 102-180 min). Median fluoroscopy time was 27 min (IQR 16-41 min).Eight patients suffered a significant complication (6%), including: one death, two infections requiring extraction, three haematomas requiring evacuation, one pneumothorax, and one tamponade. In addition there were 23 lead displacements in 19 patients (14%), and failure to implant the CRT device occurred in 17 patients (12%) (usually due to an inability to place the LV lead).Conclusions: Our patient population is similar to that of the large randomised trials from which data supporting CRT are derived. Our rates of lead dislodgement and failure to achieve device implantation are higher than reported in these trials, while our rate of other complications is similar.http://dx.