Key result
Steroid eluting and non-steroid eluting epicardial left ventricular leads demonstrated comparable electrical performance and safety in the short- and mid-term for cardiac resynchronization therapy.
Why the study?
Does a steroid eluting epicardial LV lead improve electrical performance compared to a non-steroid eluting lead in patients undergoing surgical CRT implantation?
Observational (n=32)
No
Does a steroid eluting epicardial LV lead improve electrical performance compared to a non-steroid eluting lead in patients undergoing surgical CRT implantation?
Absolute Event Rate: 1.4% vs 1%
p-value: p=0.035
Steroid-eluting and non-steroid-eluting epicardial LV leads demonstrate comparable electrical performance and safety in the short- to mid-term for patients requiring surgical CRT implantation.
Comparable performance may support either epicardial LV lead in surgical CRT; leaves open long-term outcomes and randomized trials.
BACKGROUND: We retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads (steroid eluting vs. non-steroid eluting) in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance. METHODS: Between March 2008 and May 2014 an epicardial LV lead was implanted in 32 patients after failed transvenous LV lead placement using a left-sided lateral minithoracotomy or video-assisted thoracoscopy (mean age 64 ± 9 years). Patients were divided into two groups according to the type of implanted lead. Steroid eluting (SE) group: 21 patients (Myodex™ 1084 T; St. Jude Medical) and non-steroid eluting (NSE) group: 11 patients (MyoPore® 511,212; Greatbatch Medical). RESULTS: All epicardial leads could be placed successfully, without any intraoperative complications or mortality. With regard to the implanted lead following results were observed: sensing (mV): SE 8.8 ± 6.1 vs. NSE 10.1 ± 5.3 (p = 0.380); pacing threshold (V@0.5 ms): SE 1.0 ± 0.5 vs. NSE 0.9 ± 0.5 (p = 0.668); impedance (ohms): SE 687 ± 236 vs. NSE 790 ± 331 (p = 0.162). At the follow-up (2.6 ± 1.9 years) the following results were seen: sensing (mV): SE 8.7 ± 5.0 vs. NSE 11.2 ± 6.6 (p = 0.241), pacing threshold (V@0.5 ms): SE 1.4 ± 0.5 vs. NSE 1.0 ± 0.3 (p = 0.035), impedance (ohms): SE 381 ± 95 vs. NSE 434 ± 88 (p = 0.129). CONCLUSIONS: Based on the results no strong differences have been found between the both types of epicardial LV leads (steroid eluting vs. non-steroid eluting) in CRT implantation in short- and midterm.
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Caliskan et al. (2017) conducted an observational in Heart failure requiring cardiac resynchronization therapy (n=32). Steroid eluting epicardial left ventricular leads vs. Non-steroid eluting epicardial left ventricular leads was evaluated on Pacing threshold at follow-up (V@0.5 ms) (p=0.035). Steroid eluting and non-steroid eluting epicardial left ventricular leads demonstrated comparable electrical performance and safety in the short- and mid-term for cardiac resynchronization therapy.
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