An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates
<strong>Background</strong> 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. <br> <...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Wiley
2022
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| _version_ | 1797107288004100096 |
|---|---|
| author | Robertson, C Duffey, O Tang, P-T Fairhurst, N Monteiro, C Green, P Grogono, J Davies, M Lewis, A Wijesurendra, R Ormerod, J Gamble, J Ginks, M Rajappan, K Bashir, Y Betts, TR Herring, N |
| author_facet | Robertson, C Duffey, O Tang, P-T Fairhurst, N Monteiro, C Green, P Grogono, J Davies, M Lewis, A Wijesurendra, R Ormerod, J Gamble, J Ginks, M Rajappan, K Bashir, Y Betts, TR Herring, N |
| author_sort | Robertson, C |
| collection | OXFORD |
| description | <strong>Background</strong>
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.
<br>
<strong>Methods</strong>
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.
<br>
<strong>Results</strong>
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).
<br>
<strong>Conclusion</strong>
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. |
| first_indexed | 2024-03-07T07:13:58Z |
| format | Journal article |
| id | oxford-uuid:84658879-9e64-4bb4-b5ed-15fad9f0efa2 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:13:58Z |
| publishDate | 2022 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:84658879-9e64-4bb4-b5ed-15fad9f0efa22022-07-13T16:38:37ZAn active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication ratesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:84658879-9e64-4bb4-b5ed-15fad9f0efa2EnglishSymplectic ElementsWiley2022Robertson, CDuffey, OTang, P-TFairhurst, NMonteiro, CGreen, PGrogono, JDavies, MLewis, AWijesurendra, ROrmerod, JGamble, JGinks, MRajappan, KBashir, YBetts, TRHerring, N<strong>Background</strong> 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. <br> <strong>Methods</strong> 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. <br> <strong>Results</strong> 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). <br> <strong>Conclusion</strong> 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. |
| spellingShingle | Robertson, C Duffey, O Tang, P-T Fairhurst, N Monteiro, C Green, P Grogono, J Davies, M Lewis, A Wijesurendra, R Ormerod, J Gamble, J Ginks, M Rajappan, K Bashir, Y Betts, TR Herring, N An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title | An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title_full | An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title_fullStr | An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title_full_unstemmed | An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title_short | An active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
| title_sort | active fixation quadripolar left ventricular lead for cardiac resynchronization therapy with reduced postoperative complication rates |
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