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Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation

Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian...

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Autores principales: Vogler, Julia, Geisler, Anne, Gosau, Nils, Hakmi, Samer, Willems, Stephan, Rassaf, Tienush, Wakili, Reza, Kaya, Elif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286359/
https://www.ncbi.nlm.nih.gov/pubmed/30532064
http://dx.doi.org/10.1038/s41598-018-35994-0
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author Vogler, Julia
Geisler, Anne
Gosau, Nils
Hakmi, Samer
Willems, Stephan
Rassaf, Tienush
Wakili, Reza
Kaya, Elif
author_facet Vogler, Julia
Geisler, Anne
Gosau, Nils
Hakmi, Samer
Willems, Stephan
Rassaf, Tienush
Wakili, Reza
Kaya, Elif
author_sort Vogler, Julia
collection PubMed
description Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian vein approach (SV) in CRT implantations with respect to feasibility and safety. We performed a prospective cohort study enrolling twenty-four consecutive de-novo CRT implantations (group A) using a sCV at two centers. Fifty-four age-matched CRT patients implanted via the SV served (group B) as reference. Procedural success rate and complications were recorded during a follow-up of 4 weeks. All CRTs could be implanted in group A, with 91.7% using cephalic access alone. In group B, CRT implantation was successfully performed in 96.3%. Procedure and fluoroscopy duration were similar for both groups (sCV vs. SV: 119 ± 45 vs. 106 ± 31 minutes, 17 ± 9 vs 14 ± 9 minutes). Radiation dosage was higher in sCV group vs. SV (2984 ± 2370 vs. 1580 ± 1316 cGy*cm(2); p = 0.001). There was no case of a pneumothorax in group of sCV, while two cases were observed using SV. Overall complication rate was similar (sCV: 13.0% vs. SV: 12.5%). de-novo CRT implantation using a triple cephalic vein approach is feasible. Procedure duration and complication rates were similar, while radiation dosage was higher in the sCV compared to the SV approach. Despite its feasibility in the clinical routine, controlled prospective studies with longer follow-up are required to elucidate a potential benefit with respect to lead longevity.
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spelling pubmed-62863592018-12-19 Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation Vogler, Julia Geisler, Anne Gosau, Nils Hakmi, Samer Willems, Stephan Rassaf, Tienush Wakili, Reza Kaya, Elif Sci Rep Article Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian vein approach (SV) in CRT implantations with respect to feasibility and safety. We performed a prospective cohort study enrolling twenty-four consecutive de-novo CRT implantations (group A) using a sCV at two centers. Fifty-four age-matched CRT patients implanted via the SV served (group B) as reference. Procedural success rate and complications were recorded during a follow-up of 4 weeks. All CRTs could be implanted in group A, with 91.7% using cephalic access alone. In group B, CRT implantation was successfully performed in 96.3%. Procedure and fluoroscopy duration were similar for both groups (sCV vs. SV: 119 ± 45 vs. 106 ± 31 minutes, 17 ± 9 vs 14 ± 9 minutes). Radiation dosage was higher in sCV group vs. SV (2984 ± 2370 vs. 1580 ± 1316 cGy*cm(2); p = 0.001). There was no case of a pneumothorax in group of sCV, while two cases were observed using SV. Overall complication rate was similar (sCV: 13.0% vs. SV: 12.5%). de-novo CRT implantation using a triple cephalic vein approach is feasible. Procedure duration and complication rates were similar, while radiation dosage was higher in the sCV compared to the SV approach. Despite its feasibility in the clinical routine, controlled prospective studies with longer follow-up are required to elucidate a potential benefit with respect to lead longevity. Nature Publishing Group UK 2018-12-07 /pmc/articles/PMC6286359/ /pubmed/30532064 http://dx.doi.org/10.1038/s41598-018-35994-0 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Vogler, Julia
Geisler, Anne
Gosau, Nils
Hakmi, Samer
Willems, Stephan
Rassaf, Tienush
Wakili, Reza
Kaya, Elif
Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title_full Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title_fullStr Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title_full_unstemmed Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title_short Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
title_sort triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286359/
https://www.ncbi.nlm.nih.gov/pubmed/30532064
http://dx.doi.org/10.1038/s41598-018-35994-0
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