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- Title
An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates.
- Authors
Robertson, Calum; Duffey, Owen; Tang, Pok‐Tin; Fairhurst, Natalie; Monteiro, Cristiana; Green, Peregrine; Grogono, Joanna; Davies, Mark; Lewis, Andrew; Wijesurendra, Rohan; Ormerod, Julian; Gamble, James; Ginks, Matthew; Rajappan, Kim; Bashir, Yaver; Betts, Tim R.; Herring, Neil
- Abstract
Background: The rate of left ventricular (LV) lead displacement after cardiac resynchronization therapy (CRT) remains high despite improvements in lead technology. In 2017, a novel quadripolar lead with active fixation technology became available in the UK. Methods: This was a retrospective, observational study analyzing device complications in 476 consecutive patients undergoing successful first‐time implantation of a CRT device at a tertiary center from 2017 to 2020. Results: Both active (n = 135) and passive fixation (n = 341) quadripolar leads had similar success rates for implantation (99.3% vs. 98.8%, p = 1.00), although the pacing threshold (0.89 [0.60–1.25] vs. 1.00 [0.70–1.60] V, p =.01) and lead impedance (632 [552–794] vs. 730 [636–862] Ohms, p <.0001) were significantly lower for the active fixation lead. Patients receiving an active fixation lead had a reduced incidence of lead displacement at 6 months (0.74% vs. 4.69%, p =.036). There was no significant difference in the rate of right atrial (RA) and right ventricular (RV) lead displacement between the two groups (RA: 1.48% vs. 1.17%, p =.68; RV: 2.22% vs. 1.76%, p =.72). Reprogramming the LV lead after displacement was unsuccessful in most cases (successful reprogramming: Active fix = 0/1, Passive fix = 1/16) therefore nearly all patients required a repeat procedure. As a result, the rate of intervention within 6 months for lead displacement was significantly lower when patients were implanted with the active fixation lead (0.74% vs. 4.40%, p =.049). Conclusion: The novel active fixation lead in our study has a lower incidence of lead displacement and re‐intervention compared to conventional quadripolar leads for CRT.
- Subjects
UNITED Kingdom; PREVENTION of surgical complications; CARDIAC surgery; SCIENTIFIC observation; LEFT ventricular dysfunction; RETROSPECTIVE studies; TERTIARY care; CARDIAC pacing; TREATMENT effectiveness; REOPERATION
- Publication
Journal of Cardiovascular Electrophysiology, 2022, Vol 33, Issue 3, p458
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.15346