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This a single-center, retrospective, observational study of patients that undergo coronary sinus(CS) lead revision, comparing epicardial lead placement to coronary sinus pacing(CSP) in those that had lead failure.
Cardiac resynchronization therapy with defibrillator(CRT-D) improves quality of life, functionality, and even mortality for select patients with severe heart failure with reduced ejection fraction (HFrEF). It traditionally consists of three leads placed endovascularly into the right atrium, right ventricle, and left ventricle (LV) [typically placed into the CS], known as biventricular pacing resynchronization (BVP-CRT), respectively, from which electrical stimulation enables improved cardiac synchrony. Nonetheless, the placement of a CRT-D is not without risks. Lead-related complication is high and CRT-D implantation fails in up to 30% of patients due to lead placement alone.
Epicardial lead placement and CSP have been deemed viable alternatives to CRT-D. It has even been shown to be options in patients that fail conventional BVP-CRT. This is primarily due to increased accuracy, decreased complications, and even durability. However, guidelines for decision between a transthoracic approach and CSP is unclear, even more so after lead failure. Instead, this decision is currently individualized to the patient. There is a lack of prospective and head-to-head data between the two, and this study is aimed to compare transthoracic LV epicardial lead placement and CSP in patients with lead failure after BVP-CRT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conduction System Pacing | Subjects who had lead placement via conduction system pacing approach |
| |
| Epicardial Lead Placement | Subjects who had lead placement via transthoracic, epicardial approach |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coronary Sinus Lead Revision | Other | Coronary Sinus Lead Revision |
|
| Measure | Description | Time Frame |
|---|---|---|
| Need for lead revision | Compare the need for lead revision between conduction system pacing (CSP) and transthoracic left ventricular (LV) epicardial pacing approach | Procedure Day |
| Measure | Description | Time Frame |
|---|---|---|
| Electrocardiography characteristics - QRS Interval | Compare electrocardiography characteristics - QRS Interval measured in seconds between conduction system pacing (CSP) and transthoracic left ventricular (LV) epicardial pacing approach | Procedure Day |
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Inclusion Criteria:
Exclusion Criteria:
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Adults who underwent CS lead revision, comparing epicardial lead placement to CSP in those that had lead failure.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Donita Atkins | Contact | 816-651-1969 | datkins@kchrf.com |
| Name | Affiliation | Role |
|---|---|---|
| Naga Venkata K. Pothineni | Kansas City Heart Rhythm Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kansas City Heart Rhythm Institute | Recruiting | Overland Park | Kansas | 66211 | United States |
| PubMed Identifier | Type | Citation | Retractions |
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| 34495452 |
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| Background |
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