Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies
Background: Implantable cardioverter-defibrillator (ICD) lead parameters may deteriorate due to right ventricular (RV) disease such as arrhythmogenic right ventricular cardiomyopathy (ARVC), with implications for safe delivery of therapies. We compared ICD and CRT-D (cardiac resynchronisation therap...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-03-01
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| Series: | Indian Pacing and Electrophysiology Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629218301074 |
| _version_ | 1818520577438121984 |
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| author | Jem D. Lane Sarah Whittaker-Axon Richard J. Schilling Martin D. Lowe |
| author_facet | Jem D. Lane Sarah Whittaker-Axon Richard J. Schilling Martin D. Lowe |
| author_sort | Jem D. Lane |
| collection | DOAJ |
| description | Background: Implantable cardioverter-defibrillator (ICD) lead parameters may deteriorate due to right ventricular (RV) disease such as arrhythmogenic right ventricular cardiomyopathy (ARVC), with implications for safe delivery of therapies. We compared ICD and CRT-D (cardiac resynchronisation therapy-defibrillator) lead parameters in patients with ARVC and dilated cardiomyopathy (DCM). Methods: RV lead sensing (R wave amplitude) and pacing (threshold and amplitude-pulse width product (APWP)), left ventricular (LV) pacing (APWP), and imaging parameter trends were assessed in 18 patients with ARVC and 18 with DCM. Results: R wave amplitude did not change significantly over time in either group (over 5 years, ARVC -0.4 mV, 95% CI -3.8–3.0 mV; DCM -1.8 mV, 95% CI -5.0–1.3 mV). Within ARVC group, divergent trends were seen according to lead position. DCM patients experienced an increase in RV lead threshold (+1.1 V over 5 years, 95% CI + 0.5 to +1.7 V) and RV APWP (+0.48 Vms over 5 years, 95% CI + 0.24 to +0.71 Vms); ARVC patients had no change. ARVC patients had a higher LVEF at baseline than DCM patients (52 vs 20%, p < 0.001), though LVEF decreased over time for the former, while increasing for the latter. TAPSE did not change over time for ARVC patients. Conclusions: Lead parameters in ARVC patients were stable over medium-term follow up. In DCM patients, RV lead threshold and RV and LV APWP increased over time. These differential responses for DCM and ARVC were not explained by imaging indices, and may reflect distinct patterns of disease progression. Keywords: ICD, CRT, ARVC, Lead parameters, Dilated cardiomyopathy |
| first_indexed | 2024-12-11T01:39:21Z |
| format | Article |
| id | doaj.art-132f4b425f164534a04003c0017f21aa |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-11T01:39:21Z |
| publishDate | 2019-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-132f4b425f164534a04003c0017f21aa2022-12-22T01:25:05ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922019-03-011924954Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathiesJem D. Lane0Sarah Whittaker-Axon1Richard J. Schilling2Martin D. Lowe3Department of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, United Kingdom; Department of Cardiac Electrophysiology, Heart Hospital, 16-18 Westmoreland St, Marylebone, London, W1G 8PH, United Kingdom; Corresponding author. Dept of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, 1 St Martin le Grand, West Smithfield, London, EC1A 7BE, United Kingdom.Department of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, United KingdomDepartment of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, United KingdomDepartment of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, United Kingdom; Department of Cardiac Electrophysiology, Heart Hospital, 16-18 Westmoreland St, Marylebone, London, W1G 8PH, United KingdomBackground: Implantable cardioverter-defibrillator (ICD) lead parameters may deteriorate due to right ventricular (RV) disease such as arrhythmogenic right ventricular cardiomyopathy (ARVC), with implications for safe delivery of therapies. We compared ICD and CRT-D (cardiac resynchronisation therapy-defibrillator) lead parameters in patients with ARVC and dilated cardiomyopathy (DCM). Methods: RV lead sensing (R wave amplitude) and pacing (threshold and amplitude-pulse width product (APWP)), left ventricular (LV) pacing (APWP), and imaging parameter trends were assessed in 18 patients with ARVC and 18 with DCM. Results: R wave amplitude did not change significantly over time in either group (over 5 years, ARVC -0.4 mV, 95% CI -3.8–3.0 mV; DCM -1.8 mV, 95% CI -5.0–1.3 mV). Within ARVC group, divergent trends were seen according to lead position. DCM patients experienced an increase in RV lead threshold (+1.1 V over 5 years, 95% CI + 0.5 to +1.7 V) and RV APWP (+0.48 Vms over 5 years, 95% CI + 0.24 to +0.71 Vms); ARVC patients had no change. ARVC patients had a higher LVEF at baseline than DCM patients (52 vs 20%, p < 0.001), though LVEF decreased over time for the former, while increasing for the latter. TAPSE did not change over time for ARVC patients. Conclusions: Lead parameters in ARVC patients were stable over medium-term follow up. In DCM patients, RV lead threshold and RV and LV APWP increased over time. These differential responses for DCM and ARVC were not explained by imaging indices, and may reflect distinct patterns of disease progression. Keywords: ICD, CRT, ARVC, Lead parameters, Dilated cardiomyopathyhttp://www.sciencedirect.com/science/article/pii/S0972629218301074 |
| spellingShingle | Jem D. Lane Sarah Whittaker-Axon Richard J. Schilling Martin D. Lowe Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies Indian Pacing and Electrophysiology Journal |
| title | Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| title_full | Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| title_fullStr | Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| title_full_unstemmed | Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| title_short | Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| title_sort | trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies |
| url | http://www.sciencedirect.com/science/article/pii/S0972629218301074 |
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