Extraction of SelectSecure leads compared to conventional pacing leads in patients with congenital heart disease and congenital atrioventricular block

Shepherd, Emma L.; Stuart, Graham; Rp, Martin; Walsh, Mark A.

doi:10.1016/j.hrthm.2015.03.004

Cited by 34 publications

(29 citation statements)

References 22 publications

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“…From a population of 22 attempted SelectSecure pacing lead extraction procedures, Shepherd et al. were able to extract nine SelectSecure pacing leads using simple traction alone; however, seven required the use of polypropylene sheaths and six needed a cutting sheath; average lead implant time was 4.1 years . Early data suggest an advantage for the SelectSecure pacing lead in facilitating easier lead removal if needed.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Medtronic SelectSecure and conventional pacing leads: Long‐term follow‐up in a multicenter pediatric and congenital cohort

Moak

Law

LaPage

et al. 2019

Pacing Clinical Electrophis

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Introduction:The Medtronic SelectSecure TM (Minneapolis, MN, USA) pacing lead (SS) has theoretical advantages compared to conventional (C) transvenous pacing leads (PLs). The study purpose was to determine whether differences in electrical function and lead survival exist between these PLs in a large data set of pediatric and congenital patients. Methods:A multicenter historical longitudinal cohort study was performed comparing SS and CPL performance over a 72-month follow-up (FU). Ten centers provided data for both SS and CPL, matched for age, implanted pacing chamber, time period of implantation, and presence of heart disease. Results:The cohort consisted of 141 subjects in each group. No statistical differences were observed in age, gender, presence of heart disease, or pacing indication. Atrial and ventricular capture thresholds were stable throughout FU and higher in the SS group (atrial: 0.75 ± 0.02 vs 0.5 ± 0.04 V, ventricular: 1.0 ± 0.04 vs 0.75 ± 0.04 V), P < 0.001. Group PL sensing thresholds did not differ. The SS group required greater energy to pace (atrial: 0.57 ± 0.05 vs 0.32 ± 0.02 mJ, ventricular: 0.83 ± 0.05 vs 0.56 ± 0.06 mJ), P = 0.001. Early lead dislodgement and phrenic nerve stimulation were greater in the SS group (P = 0.03). Long-term lead survival was high and similar between the two groups, P = 0.35. Conclusions:Long-term survival of both PL was high with a low fracture rate. The SS had excellent electrical function but did show higher capture thresholds and increased energy to pace; these differences are offset by other advantages of the SS PL. K E Y W O R D S adolescents and young adults, children, Medtronic SelectSecure pacing lead, pacing lead survival, Pediatric and Adult Congenital Electrophysiology Society, transvenous pacing 356

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Section: Discussionmentioning

confidence: 99%

“…Lead extraction and replacement is often required secondary to lead malfunction, need to upgrade from a pacing to implantable cardioverter defibrillator (ICD) system, patient growth, or infection. Removal of most currently available chronic pacing leads is complex, requiring expertise in pacing lead extraction with specialized tools …”

Section: Introductionmentioning

confidence: 99%

Comparison of the Medtronic SelectSecure and conventional pacing leads: Long‐term follow‐up in a multicenter pediatric and congenital cohort

Moak

Law

LaPage

et al. 2019

Pacing Clinical Electrophis

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“…In their comparison of SS and conventional pace extractions, Shepherd et al reported that the SS pacing lead appeared to be easier to extract, was less likely to be partially extracted, and was less likely to require extraction using a femoral approach. At the same time, they claimed that SS leads could easily be performed in cases of congenital heart disease and easily extracted, even if the leads remained for a long time 16 . Thus, in two recent studies, all leads, whether SS or TP, could be extracted by passive traction 10,15 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of different lead types and implantation techniques in pediatric populations with permanent pacemakers: Single‐center with 10 years' experience

Ergül

Yükçü

Öztürk

et al. 2020

Pacing Clinical Electrophis

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Background Permanent pacemaker (PM) implantation is performed for various indications and by different techniques in children; however, many problems with lead performance are encountered during follow‐up. This study aims to evaluate the possible effects of different lead types and implantation techniques on pacing at early and midterm in children with a permanent PM. Patients and methods Pediatric patients who underwent permanent PM system implantation at our tertiary cardiac surgery center between January 1, 2010 and January 1, 2020 were evaluated retrospectively. Patients were categorized in the epicardial pacing lead (EP), transvenous pacing lead (TP), and transvenous bipolar lumenless (Select Secure [SS]) lead groups according to the lead implantation technique and lead type with the same manufacturer. Groups were evaluated statistically for demographic features, pacing type and indication for implantation, lead electrical performance, lead failure, complications, and outcome. Results Over 10 years, 323 lead implantations were performed on 167 patients (96 males, median age 68 months [5 days‐18 years]). Of 323 leads, 213 (66%) were EP, 64 (20%) were TP, and 46 (14%) were SS. Of the total, 136 of the leads were implanted in atria, and 187 were implanted in ventricles. Primary pacing indications were postoperative complete atrioventricular (AV) block (n = 95), congenital AV block (n = 71), sinus node dysfunction (n = 13), and acquired complete AV block (n = 1). Additional cardiac diseases were present in 115 patients (69%). No statistically significant difference was observed in gender, syndrome, or pacing indication (P > .05). Atrial and ventricular capture, threshold, sensing, and lead impedance measurements were not significantly different at the initial and follow‐up periods (P > .05). The median follow‐up duration was 3.3 years (6 months‐10 years). Twenty lead failures were determined in 15 patients (EP: 14 lead failures in 10 patients; TP: two lead failures in two patients; and SS: four lead failures in three patients) during follow‐up, and no statistically significant difference was found between groups (P = .466). The 5‐year lead survival was 98% for TP, 95% for EP, and 90% for SS; the 10‐year lead survival was 90% for TP, 70% for EP, and 70% for SS. There was no mortality related to chronic pacing or due to the procedure of implantation. Conclusions Despite improvements in technology, lead failure is still one of the most critical problems during these patients' follow‐up. Early to midterm lead survival rates of all three lead types were satisfactory.

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“…In this study, no patients required removal of a device or leads. SelectSecure sys-tem pacing leads may be useful when they need to be removed 30) because the pacing leads have a simple internal structure such that there is no central lumen to deliver a stylet and various tools are not needed for removal. Therefore, the use of these leads is expected in cases with a high risk of infection, as in dialysis and steroid-treated patients.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Septal Pacing Using a Thin Lumenless Pacing Lead and Delivery System with a Deflectable Catheter

et al. 2018

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The SelectSecure lead system (SSLS), which is composed of a thin lumenless, active-fixation lead and a deflectable catheter, is approved for use in Japan. This study aimed to evaluate the long-term clinical outcomes of right ventricular (RV) septal pacing with the SSLS along with the system's safety and electrical performance. A total of 129 patients were divided into the following 3 groups: the RV septal pacing with the SSLS group (SSP, n = 21); the RV septal pacing with the conventional lead group (Septal, n = 77); and the RV apical pacing with the conventional lead group (Apical, n = 31). All lead-related complications and pacing parameters during follow-up were compared among the groups. The clinical outcome was heart failure-associated hospitalization. The SSP and Septal groups showed significantly shorter paced QRS duration than the Apical group. During the follow-up for a mean of 49.5 ± 13.1 months, no lead-related complications occurred in any of the groups. A case of pericardial effusion occurred in the SSP group, but cardiac tamponade did not occur, and it spontaneously resolved. The ventricular pacing threshold after the follow-up period was higher in the SSP group than in the other 2 groups. There was no difference in the primary heart failure hospitalization among the 3 groups. The SSLS could be effective in producing a narrow QRS width with RV septal pacing, but its pacing threshold was higher than conventional leads in the chronic phase.

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Extraction of SelectSecure leads compared to conventional pacing leads in patients with congenital heart disease and congenital atrioventricular block

Cited by 34 publications

References 22 publications

Comparison of the Medtronic SelectSecure and conventional pacing leads: Long‐term follow‐up in a multicenter pediatric and congenital cohort

Comparison of the Medtronic SelectSecure and conventional pacing leads: Long‐term follow‐up in a multicenter pediatric and congenital cohort

Evaluation of different lead types and implantation techniques in pediatric populations with permanent pacemakers: Single‐center with 10 years' experience

Right Ventricular Septal Pacing Using a Thin Lumenless Pacing Lead and Delivery System with a Deflectable Catheter

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