© 2001 by European Society of Cardiology
Adverse events with transvenous left ventricular pacing in patients with severe heart failure: early experience from a single centre
Department of Cardiology, Brest University Hospital France
AIMS: Assessment of complications following implantation of transvenous ventricular electrodes to pace the left ventricle.
METHODS AND RESULTS: Twenty-eight patients with severe cardiac failure and left bundle branch block were prospectively followed for adverse effects of implantation of a left ventricular transvenous pacing system. Immediate followup was associated with loss of left ventricular pacing in nine patients (32%). This was due to lead dislodgement in four cases (corrected by re-operation in three of these cases), and due to increased threshold in five cases (corrected by programming a higher pacing amplitude in all five cases, but with intermittent diaphragmatic contraction in one case). After 1 month, one patient died, one patient with severe coronary heart disease suffered a myocardial infarction, and left ventricular pacing was lost in two patients. Pericardial effusion, new significant ventricular arrhythmias or other adverse effects were not observed. After a mean follow-up of 16±9·2 months, pacing leads remained stable and no late complications related to the transvenous left ventricular epicardial pacing were observed.
CONCLUSION: Placement of a permanent lead in a tributary of the coronary sinus is feasible without serious adverse effects during the first month. The only frequent adverse event was lead dislodgement; a finding which emphasizes the need for development of specially designed leads for this application.
Key Words: Heart failure, spacing, adverse events
Correspondence: Jean-Jacques Blanc, Department of Cardiology, Brest University Hospital, France. E-mail: Jean-Jacques.Blanc{at}univ.brest.fr
[1] Cazeau S, Ritter P, Lazarus A, et al. Multisite pacing for end-stage heart failure: early experience. Pacing Clin Electrophysiol 1996; 17: 819–824.
[2] Blanc JJ, Etienne Y, Gilard M, et al. Evaluation of different ventricular pacing sites in patients with severe heart failure. Results of an acute hemodynamic study. Circulation 1997; 96: 3273–3277.
[3] Leclerq C, Cazeau S, Le Breton H, et al. Acute hemodynamic effects of biventricular DDD pacing in patients with end-stage heart failure. J Am Coll Cardiol 1998; 32: 1825–1831.
[4] Etienne Y, Mansourati J, Gilard M, et al. Evaluation of left ventricular-based in patients with congestive heart failure and atrial fibrillation. Am J Cardiol 1999; 83: 1138–1140.[CrossRef][Web of Science][Medline]
[5] Jaïs P, Douard H, Shah DC, et al. Endocardial biventricular pacing. Pacing Clin Electrophysiol 1998; 21: 2128–2131.[CrossRef][Medline]
[6] Blanc JJ, Benditt DG, Gilard M, et al. A method for permanent transvenous left ventricular pacing. Pacing Clin Electrophysiol 1998; 21: 2021–2024.[CrossRef][Medline]
[7] Daubert JC, Ritter P, Le Breton H, et al. Permanent left ventricular pacing with transvenous leads inserted into the coronary veins. Pacing Clin Electrophysiol 1998; 21: 239–245.[CrossRef][Medline]
[8] Gilard M, Mansourati J, Etienne Y, et al. Angiographic anatomy of the coronary sinus and its tributaries. Pacing Clin Electrophysiol 1998; 21: 2280–2284.[CrossRef][Medline]
[9] Kass DA, Chen CH, Curry C, et al. Improved left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay. Circulation 1999; 99: 1567–1573.
[10] Gras D, Mabo P, Tang T, et al. Multisite pacing as a supplemental treatment of congestive heart failure. Pacing Clin Electrophysiol 1998; 21: 2249–2255.[CrossRef][Medline]
[11] Tacker WA, Vanvleet JF, Schoenlern W, et al. Post-mortem changes after lead extraction from the ovine coronary sinus and great cardiac vein. Pacing Clin Electrophysiol 1998; 21: 296–302.[CrossRef][Medline]
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