The RAPIDO ADVANCE Guiding Catheter System reduced median time for left ventricular lead placement compared to the RAPIDO System (3.5 vs 8 minutes; P=0.032) during CRT implantation.
RCT (n=74)
Does the RAPIDO ADVANCE Guiding Catheter System reduce procedural times compared to the RAPIDO Guiding Catheter System in patients undergoing CRT implantation?
The RAPIDO ADVANCE telescopic dual-catheter system significantly reduces left ventricular lead positioning time compared to the RAPIDO system during CRT implantation.
Absolute Event Rate: 3.5% vs 8%
p-value: p=0.032
BACKGROUND: Implantation procedures for cardiac resynchronization therapy (CRT) remain challenging with regard to coronary sinus (CS) cannulation and left ventricular (LV) lead positioning. Technologic advances in catheter design may facilitate CS cannulation and LV lead placement. AIMS: To evaluate two different telescoping dual-catheter systems, RAPIDO Guiding Catheter System (Group R) and RAPIDO ADVANCE Guiding Catheter System (Group A) (Guidant Inc., St. Paul, MN, USA), during implantation of a CRT device. METHODS: Seventy-four consecutive patients randomly received a CRT device using the R or A system. RESULTS: An LV lead was successfully implanted in 74 patients (100%). (1) Median times for CS cannulation in groups R and A were 0.3 minutes (range from 0.05 to 14 minutes) and 0.5 minutes (range from 0.05 to 9 minutes), respectively (P = NS). (2) Median times for LV lead placement were 8 minutes (range from 0.8 to 100 minutes) and 3.5 minutes (range from 0.25 to 30 minutes), respectively, for groups R and A (P = 0.032). (3) Median total fluoroscopy times were 12.33 minutes (range from 5 to 70 minutes) and 14.33 minutes (range from 6 to 53 minutes) for groups R and A, respectively (P = NS). (4) Median procedural times for CRT implantation were 80 minutes (range from 40 to 200 minutes) and 75 minutes (range from 45 to 180 minutes) (P = NS) in groups R and A, respectively. There were no major complications. CONCLUSION: CS cannulation and LV lead placement with a telescopic dual-catheter system is a safe and feasible approach that may reduce fluoroscopy and overall CRT implantation times. Our observations suggest that the RAPIDO ADVANCE System is faster than the RAPIDO System in terms of median time for LV lead positioning.
Zanon et al. (Wed,) conducted a rct in Cardiac resynchronization therapy (CRT) implantation (n=74). RAPIDO ADVANCE Guiding Catheter System vs. RAPIDO Guiding Catheter System was evaluated on Median time for left ventricular lead placement (minutes) (p=0.032). The RAPIDO ADVANCE Guiding Catheter System reduced median time for left ventricular lead placement compared to the RAPIDO System (3.5 vs 8 minutes; P=0.032) during CRT implantation.
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