Comparative efficacy of single-coil versus dual-coil ICD leads: a meta-analysis of clinical outcomes.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Future cardiology Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI:10.1080/14796678.2025.2459542

Muhammad Hamza Shuja, Syed Hasan Shuja, Fabeeha Shaheen, Ramish Hannat, Firzah Shakil, Abeera Farooq Abbasi, Minal Hasan

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引用次数: 0

Abstract

Background: Implantable cardioverter-defibrillators (ICDs) are essential for reducing sudden cardiac death in patients at risk of ventricular arrhythmias. The choice of ICD lead - single-coil or dual-coil - can influence device performance and patient outcomes. This meta-analysis evaluates the comparative efficacy and safety of single-coil versus dual-coil ICD leads to inform clinical decision-making.

Methods: A systematic search of PubMed, Cochrane Library, and Google Scholar was performed up to October 2024. Only randomized controlled trials (RCTs) comparing single-coil and dual-coil ICD leads were included. Outcomes assessed included defibrillation threshold (DFT), first-shock efficacy, all-cause mortality, cardiovascular mortality, shock impedance, and peak current.

Results: Seven RCTs involving 1,614 patients were analyzed. Single-coil leads demonstrated superior first-shock efficacy (OR: 1.60; p = 0.05), reduced all-cause mortality (RR: 0.63; p = 0.02), and better peak current (MD: -2.29; p = 0.02). DFT and cardiovascular mortality were comparable between groups, while dual-coil leads exhibited lower shock impedance (MD: 18.26; p < 0.00001).

Conclusions: Single-coil ICD leads are associated with improved first-shock efficacy and reduced all-cause mortality, suggesting their potential superiority in certain patient populations. Further research is warranted to refine lead selection criteria.

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单线圈与双线圈ICD导联的比较疗效：临床结果荟萃分析

背景：植入式心律转复除颤器（ICDs）对于降低室性心律失常风险患者的心源性猝死至关重要。ICD引线的选择——单线圈还是双线圈——会影响设备的性能和患者的预后。本荟萃分析评估了单线圈与双线圈ICD的疗效和安全性，为临床决策提供参考。方法：系统检索PubMed、Cochrane Library和谷歌Scholar数据库，检索截止到2024年10月。仅纳入比较单线圈和双线圈ICD导联的随机对照试验（rct）。评估的结果包括除颤阈值（DFT）、首次休克疗效、全因死亡率、心血管死亡率、休克阻抗和峰值电流。结果：共分析了7项rct，共1,614例患者。单线圈引线表现出优越的首次冲击效能(OR: 1.60；p = 0.05)，全因死亡率降低(RR: 0.63；p = 0.02)，峰值电流更好(MD: -2.29；p = 0.02)。两组间DFT和心血管死亡率具有可比性，而双线圈导联表现出更低的冲击阻抗(MD: 18.26；结论：单线圈ICD导联可提高首次休克疗效，降低全因死亡率，表明其在某些患者群体中具有潜在的优势。进一步的研究是必要的，以完善铅的选择标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.