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Europace Advance Access originally published online on May 16, 2007
Europace 2007 9(7):523-527; doi:10.1093/europace/eum082
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

BIVENTRICULAR PACING

Single-centre experience with coronary sinus lead stability and long-term pacing parameters

Alan Bulava* and Jan Lukl

Department of Internal Medicine, University Hospital, Olomouc, Czech Republic

Aims To compare both short- and long-term stability and pacing parameters of CS leads. Long-term maintenance of coronary sinus (CS) pacing lead position has not yet been assessed by serial X-ray digital imaging.

Methods and results Using X-ray digital imaging in anteroposterior and left lateral views, we performed analysis of the CS lead position at the end of the implantation procedure, 48 h following implantation and after 12 months in 93 consecutive patients. Attain OTW leads, QuickSite leads and EasyTrak leads were implanted in 44, 12 and 37 cases, respectively. X-ray detectable late CS lead dislodgement was observed in 8 cases (8.6%) during 12-months follow-up. Dislodgment was once accompanied by loss of capture and need for repositioning. Another two major dislodgements occurred without any threshold change. Five (5.4%) minor dislocations occurred with either a decrease or an increase in pacing threshold. Left ventricular (LV) pacing threshold was changed by ≥ 1 V after 12 months in 14 patients (15%) when compared to values 48 h after implantation. All but one case of ≥ 1 V threshold change (either positive or negative) occurred without any radiological evidence of lead displacement. LV pacing threshold was significantly higher than RV pacing threshold at both baseline and during follow-up. Leads from all three manufacturers had comparable pacing thresholds 12 months following implantation.

Conclusion The position of CS leads may change during 1-year follow-up. However, it rarely required reoperation in the selected group of patients. Long-term pacing parameters between different manufacturers are comparable. Increase in pacing threshold is not a reliable marker of CS lead dislodgement.

Key Words: CS lead stability, Long-term performance, Biventricular pacing

* Corresponding author: Cardiocenter, Hospital Ceské Budejovice, B. Nemcové 585/54, 370 87 Ceské Budejovice, Czech Republic. Tel: +420 588443201. E-mail address: alanbulava{at}seznam.cz

Manuscript submitted 13 December 2006. Accepted after revision 30 March 2007.


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