© 2003 by European Society of Cardiology
Short and long-term single-centre experience with an S-shaped unipolar lead for left ventricular pacing
Department of Cardiology, Brest University Hospital Brest, France
Left ventricular-based pacing is an established method for treatment of congestive heart failure in patients with ventricular dyssynchrony. The transvenous epicardial approach is the method of choice to pace the left ventricle.
AIMS: To evaluate short and long-term stability and pacing and sensing performance of an S-shaped non-steroid unipolar lead.
METHODS: Forty-eight procedures were performed in 43 consecutive patients (mean age: 70±8 years, 32 males) with severe congestive heart failure. The left ventricular lead was placed into a coronary sinus tributary. Pacing and sensing thresholds and pacing impedance were measured at implant, 1 and 6 months.
RESULTS: The mean procedure time was 90·0±35·5 min. Pacing thresholds at implant, 1 and 6 months were 1·1±0·8 V, 1·9±1·3 V and 1·9±1·5 V respectively. In 7 patients, lead implantation was unsuccessful. One of them had a successful second attempt. Lead revision was performed in 5 patients for loss of capture.
CONCLUSION: The S-shaped unipolar lead evaluated in this study provides stable long-term position and pacing thresholds. Recent improvement of this S-shaped lead model will hopefully reduce the rate of implantation failures and acute dislodgements.
Key Words: Left ventricular pacing, congestive heart failure, lead implantation
Correspondence: Jean-Jacques Blanc, MD, Département de Cardiologie, CHU de la Cavale Blanche, Bd Tanguy Prigent, 29609, Brest cedex, France. Tel.: (33) 2 98 34 73 91/92; Fax: (33) 2 98 34 73 93; E-mail: Jean-Jacques.Blanc{at}univ-brest.fr
[1] Blanc JJ, Etienne Y, Gilard M, et al. Evaluation of different pacing sites in patients with severe heart failure: results of an acute hemodynamic study. Circulation 1999; 96: 3273–3277.
[2] Leclercq 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.
[3] Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronisation in chronic heart failure. N Engl J Med 2002; 346: 1845–1853.
[4] Cazeau S, Leclercq C, Lavergne T, et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 2001; 344: 873–880.
[5] Daubert JC, Ritter P, Le Breton H, et al. Permanent left ventricular pacing with transvenous leads inserted intothe coronary veins. Pacing Clin Electrophysiol 1998; 21: 239–245.[CrossRef][Medline]
[6] Blanc JJ, Benditt D, Gilard M, Etienne Y, Mansourati J, Lurie K. A method for permanent transvenous left ventricular pacing. Pacing Clin Electrophysiol 1998; 21: 2021–2024.[CrossRef][Medline]
[7] Walker S, Levy T, Rex S, Paul V. Initial results with left ventricular pacemaker lead implantation using a preformed peel-away guiding sheath and side-wire left ventricular pacing lead. Pacing Clin Electrophysiol 2000; 23: 985–990.[Medline]
[8] Pürerfellner H, Nesser HJ, Winter S, Schwierz T, Hörnell H, Maertens S. Transvenous left ventricular lead implantation with the EASYTRAK lead system: the European experience. Am J Cardiol 2000; 86: 157K–164K.[CrossRef][Web of Science][Medline]
[9] 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]
[10] Gras D, Mabo P, Tang T, et al. Multisite pacing as a supplemental treatment of congestive heart failure: preliminary results of the Medtronic Inc. InSync Study. Pacing Clin Electrophysiol 1998; 21: 2249–2255.[CrossRef][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Castellant, M. Fatemi, E. Orhan, Y. Etienne, and J. J. Blanc Patients with non-ischaemic dilated cardiomyopathy and hyper-responders to cardiac resynchronization therapy: characteristics and long-term evolution Europace, March 1, 2009; 11(3): 350 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Nagele, M. Azizi, S. Hashagen, M.A. Castel, and S. Behrens First experience with a new active fixation coronary sinus lead Europace, June 1, 2007; 9(6): 437 - 441. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Mair, J. Sachweh, B. Meuris, G. Nollert, M. Schmoeckel, A. Schuetz, B. Reichart, and S. Daebritz Surgical epicardial left ventricular lead versus coronary sinus lead placement in biventricular pacing Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 235 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-J. Blanc, M. Fatemi, V.ér. Bertault, F. Baraket, and Y. Etienne Evaluation of left bundle branch block as a reversible cause of non-ischaemic dilated cardiomyopathy with severe heart failure. A new concept of left ventricular dyssynchrony-induced cardiomyopathy Europace, January 1, 2005; 7(6): 604 - 610. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-J. Blanc, V. Bertault-Valls, M. Fatemi, M. Gilard, P.-Y. Pennec, and Y. Etienne Midterm Benefits of Left Univentricular Pacing in Patients With Congestive Heart Failure Circulation, April 13, 2004; 109(14): 1741 - 1744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V.ér. Valls-Bertault, M. Fatemi, M. Gilard, P. Y. Pennec, Y. Etienne, and J.-J. Blanc Assessment of upgrading to biventricular pacing in patients with right ventricular pacing and congestive heart failure after atrioventricular junctional ablation for chronic atrial fibrillation Europace, January 1, 2004; 6(5): 438 - 443. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||