Journal Article

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

Alan Bulava and Jan Lukl

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 7, pages 523-527
Published in print July 2007 | ISSN: 1099-5129
Published online May 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum082
Single-centre experience with coronary sinus lead stability and long-term pacing parameters

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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.

Keywords: CS lead stability; Long-term performance; Biventricular pacing

Journal Article.  2375 words.  Illustrated.

Subjects: Cardiovascular Medicine

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