Comparative Chronic Valve and Venous Effects of Lumenless versus Stylet-Delivered Pacing Leads in Patients with and Without Congenital Heart

Abstract

The lumenless, 4.1-Fr diameter PL offers improved clinical benefits, better AVV integrity, and venous development compared with larger 5-7-Fr diameter PL and should be considered especially in younger patients with/without CHD.

Ten‐Year Clinical Experience with the Lumenless, Catheter‐Delivered, 4.1‐Fr Diameter Pacing Lead in Patients with and without Congenital Heart

“…Since the maintenance of low thresholds, and associated low generator outputs which extend battery longevity, is paramount when considering pacemaker therapy in the young, this particular site was purposely not utilized. Another favorable aspect of the use of this lead is its improved clinical benefits on the integrity of atrioventricular valves and venous channels, reducing the rate of valvular insufficiency and venous obstruction when compared to the more traditional and larger diameter leads …”

“…Another favorable aspect of the use of this lead is its improved clinical benefits on the integrity of atrioventricular valves and venous channels, reducing the rate of valvular insufficiency and venous obstruction when compared to the more traditional and larger diameter leads. 6 As noted above, although a few studies have been published which report on the short-term performance of the M3830 pacing lead since its approval, the very long-term evaluation is still unknown. This limits the knowledge of chronic efficacy and also any complications that may or may not arise in association with this design, placement, and extraction.…”

“…With the advances in technology, new pacing lead designs have evolved over time, offering benefits among challenging patient groups such as those with CHD. Such new designs have improved implantation/extraction at alternative and often technically difficult sites to access, while still assuring limited complications (e.g., dislodgements, fractures, and venous occlusions), as well as causing adverse effects on valves and vasculature …”

“…Such new designs have improved implantation/extraction at alternative and often technically difficult sites to access, while still assuring limited complications (e.g., dislodgements, fractures, and venous occlusions), as well as causing adverse effects on valves and vasculature. 6 One of the newest designs is the lumenless, 4.1Fr diameter, steroid-eluting, coaxial, solid core, nonstylet, catheter-delivered lead (M3830, Medtronic, Inc., Minneapolis, MN, USA). Approved for use in the USA in 2005, the flexible catheter-delivery technique permits ease of implant at traditional (appendage/apex) as well as nonapical and appendage locations.…”

Permanent His bundle pacing: Electrophysiological and echocardiographic observations from long‐term follow‐up

“…RVP has been associated with new tricuspid regurgitation and valve abnormalities due to fibrous lesions between the lead and the tricuspid valve in addition to pulmonary hypertension resulting from LV dysfunction . A recent study showed reduced incidence of tricuspid valve abnormalities and venous stenosis with the Medtronic 3830 pacing lead compared to traditional RV pacing leads attributed to the smaller lead diameter (4.1 Fr) . During the entire follow‐up period, there were only two HFHs in our series despite high HBP burden.…”