Effectiveness of single- vs dual-coil implantable defibrillator leads: An observational analysis from the SIMPLE study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F19%3A00078262" target="_blank" >RIV/00023001:_____/19:00078262 - isvavai.cz</a>

Result on the web

<a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.13943" target="_blank" >https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.13943</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/jce.13943" target="_blank" >10.1111/jce.13943</a>

Result language

angličtina

Original language name

Effectiveness of single- vs dual-coil implantable defibrillator leads: An observational analysis from the SIMPLE study

Original language description

Introduction Dual-coil leads (DC-leads) were the standard of choice since the first nonthoracotomy implantable cardioverter/defibrillator (ICD). We used contemporary data to determine if DC-leads offer any advantage over single-coil leads (SC-leads), in terms of defibrillation efficacy, safety, clinical outcome, and complication rates. Methods and Results In the Shockless IMPLant Evaluation study, 2500 patients received a first implanted ICD and were randomized to implantation with or without defibrillation testing. Two thousand and four hundred seventy-five patients received SC-coil or DC-coil leads (SC-leads in 1025/2475 patients; 41.4%). In patients who underwent defibrillation testing (n = 1204), patients with both lead types were equally likely to achieve an adequate defibrillation safety margin (88.8% vs 91.2%; P = 0.16). There was no overall effect of lead type on the primary study endpoint of &quot;failed appropriate shock or arrhythmic death&quot; (adjusted HR 1.18; 95% CI, 0.86-1.62; P = 0.300), and on all-cause mortality (SC-leads: 5.34%/year; DC-leads: 5.48%/year; adjusted HR 1.16; 95% CI, 0.94-1.43; P = 0.168). However, among patients without prior heart failure (HF), and SC-leads had a significantly higher risk of failed appropriate shock or arrhythmic death (adjusted HR 7.02; 95% CI, 2.41-20.5). There were no differences in complication rates. Conclusion In this nonrandomized evaluation, there was no overall difference in defibrillation efficacy, safety, outcome, and complication rates between SC-leads and DC-leads. However, DC-leads were associated with a reduction in the composite of failed appropriate shock or arrhythmic death in the subgroup of non-HF patients. Considering riskier future lead extraction with DC-leads, SC-leads appears to be preferable in the majority of patients.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of cardiovascular electrophysiology

ISSN

1045-3873

e-ISSN

—

Volume of the periodical

30

Issue of the periodical within the volume

7

Country of publishing house

US - UNITED STATES

Number of pages

8

Pages from-to

1078-1085

UT code for WoS article

000476777200010

EID of the result in the Scopus database

2-s2.0-85064686777