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Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy
(1) Background: Limited data exist on the safety and efficacy of epicardial left ventricular (LV) lead placement using video-assisted thoracoscopic surgery (VATS) for cardiac resynchronization therapy (CRT). (2) Methods: Acute and post-discharge outcomes of CRT were compared between patients with ep...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145737/ https://www.ncbi.nlm.nih.gov/pubmed/35621871 http://dx.doi.org/10.3390/jcdd9050160 |
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author | Kim, Hye Ree Lim, Kyunghee Park, Seung-Jung Park, Jong-Sung Kim, Ju Youn Chung, Suryeun Jung, Dong-Seop Park, Kyoung-Min On, Young Keun Kim, June Soo |
author_facet | Kim, Hye Ree Lim, Kyunghee Park, Seung-Jung Park, Jong-Sung Kim, Ju Youn Chung, Suryeun Jung, Dong-Seop Park, Kyoung-Min On, Young Keun Kim, June Soo |
author_sort | Kim, Hye Ree |
collection | PubMed |
description | (1) Background: Limited data exist on the safety and efficacy of epicardial left ventricular (LV) lead placement using video-assisted thoracoscopic surgery (VATS) for cardiac resynchronization therapy (CRT). (2) Methods: Acute and post-discharge outcomes of CRT were compared between patients with epicardial LV leads (Epicardial-LV group, n = 13) and those with endocardial LV leads (Endocardial-LV group, n = 243). (3) Results: Epicardial LV leads were implanted via VATS alone (n = 8) or along with mini-thoracotomy (n = 5), for failed endocardial implantation (n = 11) or recurrent lead dislodgement (n = 2). All epicardial procedures under general anesthesia with one-lung ventilation were successfully completed in 1.0 ± 0.4 h without phrenic nerve stimulation. LV pacing thresholds in the epicardial-LV (1.5 ± 1.0 V) and endocardial-LV (1.3 ± 0.8 V) were comparable (p = 0.651). All patients were discharged alive post-VATS 8.8 ± 3.9 days. During the follow-up (34.3 ± 28.6 months), all patients with epicardial LV leads stayed alive except for one cardiac death post-CRT 14 months and one heart transplantation post-CRT 30 months. All epicardial LV leads maintained stable performance without dislodgement/significant changes in pacing threshold/impedance. LV lead dislodgement occurred only in endocardial-LV (7/243, 2.9%). Efficacy in both groups was comparable in terms of QRS narrowing, increase in LV ejection fraction, and survival free of cardiac death, or heart-failure-related hospitalization. (4) Conclusions: Epicardial LV lead placement using VATS can be a safe and effective alternative to endocardial implantation, with comparable acute and post-discharge outcomes achieved by both approaches. |
format | Online Article Text |
id | pubmed-9145737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91457372022-05-29 Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy Kim, Hye Ree Lim, Kyunghee Park, Seung-Jung Park, Jong-Sung Kim, Ju Youn Chung, Suryeun Jung, Dong-Seop Park, Kyoung-Min On, Young Keun Kim, June Soo J Cardiovasc Dev Dis Article (1) Background: Limited data exist on the safety and efficacy of epicardial left ventricular (LV) lead placement using video-assisted thoracoscopic surgery (VATS) for cardiac resynchronization therapy (CRT). (2) Methods: Acute and post-discharge outcomes of CRT were compared between patients with epicardial LV leads (Epicardial-LV group, n = 13) and those with endocardial LV leads (Endocardial-LV group, n = 243). (3) Results: Epicardial LV leads were implanted via VATS alone (n = 8) or along with mini-thoracotomy (n = 5), for failed endocardial implantation (n = 11) or recurrent lead dislodgement (n = 2). All epicardial procedures under general anesthesia with one-lung ventilation were successfully completed in 1.0 ± 0.4 h without phrenic nerve stimulation. LV pacing thresholds in the epicardial-LV (1.5 ± 1.0 V) and endocardial-LV (1.3 ± 0.8 V) were comparable (p = 0.651). All patients were discharged alive post-VATS 8.8 ± 3.9 days. During the follow-up (34.3 ± 28.6 months), all patients with epicardial LV leads stayed alive except for one cardiac death post-CRT 14 months and one heart transplantation post-CRT 30 months. All epicardial LV leads maintained stable performance without dislodgement/significant changes in pacing threshold/impedance. LV lead dislodgement occurred only in endocardial-LV (7/243, 2.9%). Efficacy in both groups was comparable in terms of QRS narrowing, increase in LV ejection fraction, and survival free of cardiac death, or heart-failure-related hospitalization. (4) Conclusions: Epicardial LV lead placement using VATS can be a safe and effective alternative to endocardial implantation, with comparable acute and post-discharge outcomes achieved by both approaches. MDPI 2022-05-16 /pmc/articles/PMC9145737/ /pubmed/35621871 http://dx.doi.org/10.3390/jcdd9050160 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kim, Hye Ree Lim, Kyunghee Park, Seung-Jung Park, Jong-Sung Kim, Ju Youn Chung, Suryeun Jung, Dong-Seop Park, Kyoung-Min On, Young Keun Kim, June Soo Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title | Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title_full | Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title_fullStr | Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title_full_unstemmed | Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title_short | Thoracoscopic Implantation of Epicardial Left Ventricular Lead for Cardiac Resynchronization Therapy |
title_sort | thoracoscopic implantation of epicardial left ventricular lead for cardiac resynchronization therapy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145737/ https://www.ncbi.nlm.nih.gov/pubmed/35621871 http://dx.doi.org/10.3390/jcdd9050160 |
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