January 26, 2011EP Europace
The effect of electronic repositioning on left ventricular pacing and phrenic nerve stimulation
Key result
Electronic repositioning reduced pacing thresholds by ≥1.0 V in 35% of patients and eliminated phrenic nerve stimulation in 77% of affected cases without requiring lead revision.
Why the study?
Does electronic repositioning of LV pacing vectors improve pacing thresholds and prevent phrenic nerve stimulation in patients undergoing CRT implantation?
Population
228 patients undergoing cardiac resynchronization therapy implantation between 2004 and 2007.
Comparison
Electronic repositioning/reprogramming of left… vs Standard LVtip to LVring configuration.
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
May reduce lead revisions in CRT; leaves open whether randomized trials confirm clinical benefit.
Study Design
Type
Cohort (n=228)
Structured PICO
Does electronic repositioning of LV pacing vectors improve pacing thresholds and prevent phrenic nerve stimulation in patients undergoing CRT implantation?
P
Population
228 patients undergoing cardiac resynchronization therapy implantation with a bipolar left ventricular lead, evaluated prospectively at baseline and 6 months.
E
Exposure
Electronic repositioning/reprogramming of left ventricular (LV) pacing vectors.
C
Comparator
Standard LVtip to LVring configuration.
O
Outcome
Optimal LV pacing threshold and avoidance of phrenic nerve stimulation at baseline and 6 months.surrogate
Electronic repositioning of LV pacing vectors effectively lowers pacing thresholds and avoids phrenic nerve stimulation, potentially reducing the need for lead revision surgeries in CRT patients.
Cite This Study
Champagne et al. (2011) conducted a cohort in Heart failure requiring cardiac resynchronization therapy (n=228). Electronic repositioning (reprogramming of left ventricular pacing vectors) vs. Standard LVtip to LVring configuration was evaluated on Reduction in pacing threshold and avoidance of phrenic nerve stimulation. Electronic repositioning reduced pacing thresholds by ≥1.0 V in 35% of patients and eliminated phrenic nerve stimulation in 77% of affected cases without requiring lead revision.