Leadless left ventricular endocardial pacing for CRT upgrades in previously failed and high-risk patients in comparison with coronary sinus CRT upgrades

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023884%3A_____%2F21%3A00009117" target="_blank" >RIV/00023884:_____/21:00009117 - isvavai.cz</a>

Result on the web

<a href="https://academic-oup-com.ezproxy.lib.cas.cz/europace/article/23/10/1577/6329891" target="_blank" >https://academic-oup-com.ezproxy.lib.cas.cz/europace/article/23/10/1577/6329891</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/europace/euab156" target="_blank" >10.1093/europace/euab156</a>

Result language

angličtina

Original language name

Leadless left ventricular endocardial pacing for CRT upgrades in previously failed and high-risk patients in comparison with coronary sinus CRT upgrades

Original language description

Aims Cardiac resynchronization therapy (CRT) upgrades may be Less Likely to improve following intervention. Leadless left ventricular (LV) endocardial pacing has been used for patients with previously failed CRT or high-risk upgrades. We compared procedural and long-term outcomes in patients undergoing coronary sinus (CS) CRT upgrades with high-risk and previously failed CRT upgrades undergoing LV endocardial upgrades. Method and results Prospective consecutive CS upgrades between 2015 and 2019 were compared with those undergoing WiSE-CRT implantation. Cardiac resynchronization therapy response at 6 months was defined as improvement in clinical composite score (CCS) and a reduction in LV end-systolic volume (LVESV) >= 15%. A total of 225 patients were analysed; 121 CS and 104 endocardial upgrades. Patients receiving WISE-CRT tended to have more comorbidities and were more likely to have previous cardiac surgery (30.9% vs. 16.5%; P=0.012), hypertension (59.2% vs. 34.7%; P< 0.001), chronic obstructive airways disease (19.4% vs. 9.9%; P=0.046), and chronic kidney disease (46.4% vs. 21.5%; P< 0.01) but similar LV ejection fraction (30.0 +/- 8.3% vs. 29.5 +/- 8.6%; P= 0.678). WiSE-CRT upgrades were successful in 97.1% with procedure-related mortality in 1.9%. Coronary sinus upgrades were successful in 97.5% of cases with a 2.5% rate of CS dissection and 5.6% lead malfunction/displacement. At 6 months, 91 WiSE-CRT upgrades and 107 CS upgrades had similar improvements in CCS (76.3% vs. 68.5%; P= 0.210) and reduction in LVESV >= 15% (54.2% vs. 56.3%; P = 0.835). Conclusion Despite prior failed upgrades and high-risk patients with more comorbidities, WiSE-CRT upgrades had high rates of procedural success and similar improvements in CCS and LV remodelling with CS upgrades.

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

2021

Confidentiality

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

Name of the periodical

EP Europace

ISSN

1099-5129

e-ISSN

—

Volume of the periodical

23

Issue of the periodical within the volume

10

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

1577-1585

UT code for WoS article

000713681500009

EID of the result in the Scopus database

2-s2.0-85118285828