Procedural Success of Left Ventricular Lead Placement for Cardiac Resynchronization Therapy

Gamble, James; Herring, Neil; Ginks, Matthew; Rajappan, Kim; Bashir, Yaver; Betts, Timothy R.

doi:10.1016/j.jacep.2015.08.009

Cited by 73 publications

(66 citation statements)

References 26 publications

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“…For successful implants, the mean CS cannulation time reported in the study was 10.6 minutes (±19.5 minutes) and the mean final lead placement time was 17.1 minutes (±25.2 minutes). The time to cannulate the CS was less than half that of the time to place the LVL in contrast to prior experience where the greatest challenge was CS cannulation, supporting evidence that the design and use of delivery catheters has been greatly improved . At the same time, the duration of LVL implant remains unpredictable with significant variation and we have limited data on the implant failures.…”

Section: Discussionmentioning

confidence: 51%

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Real‐World Assessment of Acute Left Ventricular Lead Implant Success and Complication Rates: Results from the Attain Success Clinical Trial

Hummel

Coppess

Osborn

et al. 2016

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 51%

“…The duration of the LVL implant has significant ramifications in terms of procedural outcomes . For successful implants, the mean CS cannulation time reported in the study was 10.6 minutes (±19.5 minutes) and the mean final lead placement time was 17.1 minutes (±25.2 minutes).…”

Section: Discussionmentioning

confidence: 94%

Real‐World Assessment of Acute Left Ventricular Lead Implant Success and Complication Rates: Results from the Attain Success Clinical Trial

Hummel

Coppess

Osborn

et al. 2016

Pacing Clinical Electrophis

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“…The most common reasons for this were lead displacement and rise in pacing threshold. This is similar to the 6.7% rate reported in a prior long term follow‐up study of His bundle pacing and is comparable to the approximately 7% LV lead revision rate seen in 15 222 patients included in the studies of biventricular pacing . Indeed, given the decades more of technical developments for RV leads, it is remarkable that the rate of RV lead repeat interventions is still even now as high as 3% .…”

Section: Discussionmentioning

confidence: 99%

His bundle pacing, learning curve, procedure characteristics, safety, and feasibility: Insights from a large international observational study

Keene

Arnold

Jastrzębski

et al. 2019

Cardiovasc electrophysiol

148

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Background His‐bundle pacing (HBP) provides physiological ventricular activation. Observational studies have demonstrated the techniques’ feasibility; however, data have come from a limited number of centers. Objectives We set out to explore the contemporary global practice in HBP focusing on the learning curve, procedural characteristics, and outcomes. Methods This is a retrospective, multicenter observational study of patients undergoing attempted HBP at seven centers. Pacing indication, fluoroscopy time, HBP thresholds, and lead reintervention and deactivation rates were recorded. Where centers had systematically recorded implant success rates from the outset, these were collated. Results A total of 529 patients underwent attempted HBP during the study period (2014‐19) with a mean follow‐up of 217 ± 303 days. Most implants were for bradycardia indications. In the three centers with the systematic collation of all attempts, the overall implant success rate was 81%, which improved to 87% after completion of 40 cases. All seven centers reported data on successful implants. The mean fluoroscopy time was 11.7 ± 12.0 minutes, the His‐bundle capture threshold at implant was 1.4 ± 0.9 V at 0.8 ± 0.3 ms, and it was 1.3 ± 1.2 V at 0.9 ± 0.2 ms at last device check. HBP lead reintervention or deactivation (for lead displacement or rise in threshold) occurred in 7.5% of successful implants. There was evidence of a learning curve: fluoroscopy time and HBP capture threshold reduced with greater experience, plateauing after approximately 30‐50 cases. Conclusion We found that it is feasible to establish a successful HBP program, using the currently available implantation tools. For physicians who are experienced at pacemaker implantation, the steepest part of the learning curve appears to be over the first 30‐50 cases.

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“…Patients receiving cardiac resynchronisation therapy (CRT) have an additional risk of failure to place left ventricular (LV) lead, and LV lead displacement of 3-5%. 3 …”

Section: Complicationsmentioning

confidence: 99%

An Update on Cardiac Implantable Electronic Devices for the General Physician

Peal¹,

Mathews

Runnett

et al. 2018

Journal of the Royal College of Physicians of Edinburgh

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Cardiac electronic device implantation is a common and important intervention for patients with tachy- and bradyarrhythmia. An increasing number of patients are receiving more complex devices such as cardiac resynchronisation therapy or devices with a defibrillation function. Over the last 5 years, two new models of cardiac device have emerged, subcutaneous defibrillators and leadless pacemakers. With an ageing population and data demonstrating 2000 per 100,000 of the population aged over 75 years have a cardiac device, it is essential that the general physician remains updated on the common pacemaker indications and available therapies.

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Procedural Success of Left Ventricular Lead Placement for Cardiac Resynchronization Therapy

Abstract: The reported rate of failure to place an LV lead via the CS has decreased steadily over time. A greater proportion of failures in recent studies are due to coronary venous anatomy that is unsuitable for this technique.

Cited by 73 publications

References 26 publications

Real‐World Assessment of Acute Left Ventricular Lead Implant Success and Complication Rates: Results from the Attain Success Clinical Trial

Real‐World Assessment of Acute Left Ventricular Lead Implant Success and Complication Rates: Results from the Attain Success Clinical Trial

His bundle pacing, learning curve, procedure characteristics, safety, and feasibility: Insights from a large international observational study

An Update on Cardiac Implantable Electronic Devices for the General Physician

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