Key result
Medtronic and Guidant delivery systems for left ventricular pacing showed no significant differences in complication rates, including coronary sinus dissection (5% vs 6%, P=NS).
Why the study?
Do different coronary sinus leads and delivery systems have different complication rates in patients undergoing left ventricular pacing?
Observational (n=249)
Do different coronary sinus leads and delivery systems have different complication rates in patients undergoing left ventricular pacing?
Absolute Event Rate: 5% vs 6%
p-value: p=NS
There are no significant differences in complication rates between Medtronic and Guidant delivery systems and leads for left ventricular pacing.
Comparable complication rates between systems support similar safety profiles; observational data leaves open need for randomized confirmation before guiding selection.
AIMS: To compare different coronary sinus (CS) leads and delivery systems (DSs) for left ventricular pacing. METHODS AND RESULTS: Delivery systems-related (including CS dissection and dislocations during sheath/stylet removal) and lead-related (including failure to accomplish implantations and long-term malfunctions resulting in abandonment or repositioning/replacing of the lead) complications between systems and leads were compared. We used Medtronic (MDT) attain DS (n = 123) with over-the-wire (OTW) (4193, 4194) and stylet-driven (2187) leads, and Guidant (GDT) DS (n = 126) with Easytrak OTW leads (4513, 4518, and 4525). Coronory sinus dissection occurred in 6/123 (5%) cases using the MDT DS vs. 7/126 (6%) with GDT DS (P= NS). Dislocations during sheath/stylet removal occurred in 8/123 cases (6%) with MDT DS, and in 8/126 (6%) with GDT DS (P= NS). Failure to achieve successful implantation occurred in 6/32 (19%) of the 2187 leads, in 11/87(13%) of the 4193/4194 leads, in 7/94(7%) of the 4513/4518 leads, and in 4/29 (14%) of the 4525 leads (P= NS). Long-term lead-related complications occurred in 5/32 (15%) of the 2187 leads, 19/80 (23%) of the 4193/4194 leads, 19/93 (20%) of the 4513/4518 leads, and 2/28 (7%) of the 4525 leads (P= NS). CONCLUSION: No significant differences in complication rates between systems and leads were observed.
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Nof et al. (2007) conducted an observational in Left ventricular pacing (n=249). Medtronic (MDT) attain delivery system and leads vs. Guidant (GDT) delivery system and leads was evaluated on Coronary sinus dissection (p=NS). Medtronic and Guidant delivery systems for left ventricular pacing showed no significant differences in complication rates, including coronary sinus dissection (5% vs 6%, P=NS).
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