Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy: prevalence, causes and outcomes

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Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy : prevalence, causes and outcomes. / Witt, Christoffer Tobias; Ng Kam Chuen, Marie Jennyfer; Kronborg, Mads Brix et al.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 63, No. 1, 01.2022, p. 69-75.

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Witt CT, Ng Kam Chuen MJ, Kronborg MB, Kristensen J, Gerdes C, Nielsen JC. Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy: prevalence, causes and outcomes. Journal of Interventional Cardiac Electrophysiology. 2022 Jan;63(1):69-75. Epub 2021 Feb 1. doi: 10.1007/s10840-021-00947-7

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Witt, Christoffer Tobias ; Ng Kam Chuen, Marie Jennyfer ; Kronborg, Mads Brix et al. / Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy : prevalence, causes and outcomes. In: Journal of Interventional Cardiac Electrophysiology. 2022 ; Vol. 63, No. 1. pp. 69-75.

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@article{c5d8ba76c9dc476d86de4aaadf44bf26,
title = "Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy: prevalence, causes and outcomes",
abstract = "PURPOSE: Left ventricular (LV) lead complications in cardiac resynchronization therapy are challenging and poorly reported. We aimed to establish prevalence, causes and outcomes of LV lead complications requiring re-intervention.METHODS: We analysed the rate of complications in 2551 consecutive patients who received a transvenous de novo LV lead as part of a cardiac resynchronization therapy device between 2000 and 2018. LV lead complications requiring re-intervention were identified; those due to infection were excluded. Patient, procedural and device characteristics, and outcomes were examined for non-infective LV lead complications requiring re-intervention.RESULTS: During a median of 4.7 years, 142 (5.6%) patients required re-intervention for non-infective LV lead complications with a decrease from 10.7% between 2000 and 2004, 8.7% between 2005 and 2009, 3.2% between 2010 and 2014 to 3.2% after 2014. The most common complications were LV lead displacement (50%), high pacing threshold (28%) and phrenic nerve stimulation (15%). Of the complications, 79 (56%) occurred within 90 days post-implant and 63 (44%) later. At the end of the study period, 132/142 patients (93%) had a functional LV lead. Lead re-intervention was associated with higher risk of complications (20%), but no increase in mortality (P = 0.19). Quadripolar leads had longer longevity and lower risk of complications compared with unipolar and bipolar LV leads.CONCLUSIONS: A small but significant proportion of patients required LV lead re-intervention for complications following de novo implant. Lead displacement accounted for half of the re-interventions. Re-intervention was associated with a higher complication rate, but 92% of these patients had functional LV leads at the end of follow-up.",
keywords = "Cardiac resynchronization therapy complications, LV lead complications, LV lead outcomes, LV lead re-intervention, Prevalence, Humans, Treatment Outcome, Heart Failure/therapy, Cardiac Resynchronization Therapy Devices, Cardiac Resynchronization Therapy",
author = "Witt, {Christoffer Tobias} and {Ng Kam Chuen}, {Marie Jennyfer} and Kronborg, {Mads Brix} and Jens Kristensen and Christian Gerdes and Nielsen, {Jens Cosedis}",
year = "2022",
month = jan,
doi = "10.1007/s10840-021-00947-7",
language = "English",
volume = "63",
pages = "69--75",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - Non-infective left ventricular lead complications requiring re-intervention following cardiac resynchronization therapy

T2 - prevalence, causes and outcomes

AU - Witt, Christoffer Tobias

AU - Ng Kam Chuen, Marie Jennyfer

AU - Kronborg, Mads Brix

AU - Kristensen, Jens

AU - Gerdes, Christian

AU - Nielsen, Jens Cosedis

PY - 2022/1

Y1 - 2022/1

N2 - PURPOSE: Left ventricular (LV) lead complications in cardiac resynchronization therapy are challenging and poorly reported. We aimed to establish prevalence, causes and outcomes of LV lead complications requiring re-intervention.METHODS: We analysed the rate of complications in 2551 consecutive patients who received a transvenous de novo LV lead as part of a cardiac resynchronization therapy device between 2000 and 2018. LV lead complications requiring re-intervention were identified; those due to infection were excluded. Patient, procedural and device characteristics, and outcomes were examined for non-infective LV lead complications requiring re-intervention.RESULTS: During a median of 4.7 years, 142 (5.6%) patients required re-intervention for non-infective LV lead complications with a decrease from 10.7% between 2000 and 2004, 8.7% between 2005 and 2009, 3.2% between 2010 and 2014 to 3.2% after 2014. The most common complications were LV lead displacement (50%), high pacing threshold (28%) and phrenic nerve stimulation (15%). Of the complications, 79 (56%) occurred within 90 days post-implant and 63 (44%) later. At the end of the study period, 132/142 patients (93%) had a functional LV lead. Lead re-intervention was associated with higher risk of complications (20%), but no increase in mortality (P = 0.19). Quadripolar leads had longer longevity and lower risk of complications compared with unipolar and bipolar LV leads.CONCLUSIONS: A small but significant proportion of patients required LV lead re-intervention for complications following de novo implant. Lead displacement accounted for half of the re-interventions. Re-intervention was associated with a higher complication rate, but 92% of these patients had functional LV leads at the end of follow-up.

AB - PURPOSE: Left ventricular (LV) lead complications in cardiac resynchronization therapy are challenging and poorly reported. We aimed to establish prevalence, causes and outcomes of LV lead complications requiring re-intervention.METHODS: We analysed the rate of complications in 2551 consecutive patients who received a transvenous de novo LV lead as part of a cardiac resynchronization therapy device between 2000 and 2018. LV lead complications requiring re-intervention were identified; those due to infection were excluded. Patient, procedural and device characteristics, and outcomes were examined for non-infective LV lead complications requiring re-intervention.RESULTS: During a median of 4.7 years, 142 (5.6%) patients required re-intervention for non-infective LV lead complications with a decrease from 10.7% between 2000 and 2004, 8.7% between 2005 and 2009, 3.2% between 2010 and 2014 to 3.2% after 2014. The most common complications were LV lead displacement (50%), high pacing threshold (28%) and phrenic nerve stimulation (15%). Of the complications, 79 (56%) occurred within 90 days post-implant and 63 (44%) later. At the end of the study period, 132/142 patients (93%) had a functional LV lead. Lead re-intervention was associated with higher risk of complications (20%), but no increase in mortality (P = 0.19). Quadripolar leads had longer longevity and lower risk of complications compared with unipolar and bipolar LV leads.CONCLUSIONS: A small but significant proportion of patients required LV lead re-intervention for complications following de novo implant. Lead displacement accounted for half of the re-interventions. Re-intervention was associated with a higher complication rate, but 92% of these patients had functional LV leads at the end of follow-up.

KW - Cardiac resynchronization therapy complications

KW - LV lead complications

KW - LV lead outcomes

KW - LV lead re-intervention

KW - Prevalence

KW - Humans

KW - Treatment Outcome

KW - Heart Failure/therapy

KW - Cardiac Resynchronization Therapy Devices

KW - Cardiac Resynchronization Therapy

U2 - 10.1007/s10840-021-00947-7

DO - 10.1007/s10840-021-00947-7

M3 - Journal article

C2 - 33523328

VL - 63

SP - 69

EP - 75

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

SN - 1383-875X

IS - 1

ER -