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Clinical Research in Cardiology

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24.05.2018 | Original Paper

ICD lead type and RV lead position in CRT-D recipients

verfasst von: Alexander P. Benz, Mate Vamos, Julia W. Erath, Peter Bogyi, Gabor Z. Duray, Stefan H. Hohnloser

Erschienen in: Clinical Research in Cardiology | Ausgabe 12/2018

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Abstract

Background

Data on preferred ICD lead type and optimal RV lead position in patients undergoing CRT-D implantation are limited.

Objectives

To compare dual- versus single-coil ICD leads and non-apical versus apical RV lead position and their impact on clinical parameters and survival in CRT-D recipients.

Methods

A total of 563 consecutive patients with advanced heart failure and indication for CRT-D implantation were enrolled in two European tertiary centers. Endpoints were improvement in NYHA functional class, changes in echo- and electrocardiographic parameters, and all-cause and cardiovascular mortality.

Results

In this retrospective analysis, a total of 313 (56%) dual- and 250 (44%) single-coil ICD leads were used. RV leads were placed non-apically in 262 (47%) and apically in 296 (53%) patients, respectively. Over a mean follow-up of 41 ± 34 months, all-cause mortality and cardiovascular mortality were similar for patients with dual- versus single-coil ICD lead (adjusted HR 0.81, 95% CI 0.58–1.12 and aHR 1.22, 95% CI 0.73–2.04) and non-apical versus apical RV lead position (aHR 0.98, 95% CI 0.71–1.36 and aHR 0.76, 95% CI 0.44–1.31). Non-apical RV lead position was associated with greater reduction in QRS duration after CRT implantation (− 14.4 ± 32.1 vs. − 4.3 ± 34.3 ms, p < 0.001).

Conclusions

We found no association between ICD lead type or RV lead position and outcomes in CRT-D recipients. Non-apical RV lead position was associated with larger reduction in QRS duration.

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Titel: ICD lead type and RV lead position in CRT-D recipients
verfasst von: Alexander P. Benz
Mate Vamos
Julia W. Erath
Peter Bogyi
Gabor Z. Duray
Stefan H. Hohnloser
Publikationsdatum: 24.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 12/2018
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1286-3

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ICD lead type and RV lead position in CRT-D recipients

Abstract

Background

Objectives

Methods

Results

Conclusions

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Abstract

Background

Objectives

Methods

Results

Conclusions

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