Event‐Free Survival Following CRT with Surgically Implanted LV Leads Versus Standard Transvenous Approach
Key result
Isolated surgical LV lead placement was associated with a higher early risk of events in the first 3 months compared to transvenous placement (HR 1.8; 95% CI 1.1-2.7; P=0.02).
Why the study?
Does surgical epicardial LV lead placement compared to transvenous placement affect event-free survival in patients undergoing CRT?
Population
480 consecutive patients undergoing left ventricle lead placement for cardiac resynchronization therapy
Comparison
Surgical epicardial LV lead placement vs Standard transvenous LV lead placement
Design
Cohort
Authors
Discussion
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Member takes
Implication
May warrant caution with isolated surgical LV leads early after CRT; hypothesis-generating for randomized confirmation.
Study Design
Type
Cohort (n=480)
Multicenter
No
Structured PICO
Does surgical epicardial LV lead placement compared to transvenous placement affect event-free survival in patients undergoing CRT?
P
Population
480 consecutive patients undergoing surgical or percutaneous left ventricle lead placement for cardiac resynchronization therapy.
E
Exposure
Surgical epicardial LV lead placement (n=48, including 28 with isolated surgical lead placement)
C
Comparator
Standard transvenous (percutaneous) LV lead placement (n=432)
O
Outcome
Long-term event-free survivalhard clinical
Main Result
Hazard Ratio: 1.3 (95% CI 1–1.7)
p-value: p=0.07
Isolated surgical LV lead placement for CRT carries a significant early mortality risk compared to the transvenous approach, though long-term survival is similar.
Cite This Study
Miller et al. (2011) conducted a cohort in Cardiac resynchronization therapy (CRT) (n=480). Surgical left ventricle (LV) lead placement vs. Percutaneous (transvenous) LV lead placement was evaluated on Long-term event-free survival (HR 1.3, 95% CI 1.0-1.7, p=0.07). Isolated surgical LV lead placement was associated with a higher early risk of events in the first 3 months compared to transvenous placement (HR 1.8; 95% CI 1.1-2.7; P=0.02).