Key result
Endocardial LV pacing is associated with similar ischaemic stroke risk to conventional CS leads.
Why the study?
Does endocardial left ventricular pacing increase thrombo-embolic risk compared to conventional coronary sinus leads in heart failure patients?
Population
204 heart failure patients
Comparison
Endocardial left ventricular (LV) pacing vs Conventional coronary sinus (CS) leads
Design
Cohort
Follow-up
mean 20 months (endocardial arm) and 23 months (control arm)
Authors
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Comparable thromboembolic risk to CS leads when INR therapeutic; leaves open need for RCTs on NOACs before broader use.
Cohort (n=204)
Yes
Does endocardial left ventricular pacing increase thrombo-embolic risk compared to conventional coronary sinus leads in heart failure patients?
Absolute Event Rate: 6% vs 6.6%
Endocardial LV pacing has a similar long-term thrombo-embolic risk to conventional CS leads, though stroke risk is strongly associated with sub-therapeutic anticoagulation.
Sawhney et al. (2018) conducted a cohort in Heart failure with failed coronary sinus lead implantation (n=204). Endocardial left ventricular pacing vs. Conventional coronary sinus leads was evaluated on Ischaemic stroke. Endocardial left ventricular pacing was associated with a 6% rate of ischaemic stroke, comparable to the 6.6% rate observed with conventional coronary sinus leads.
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