Transvenous extraction of quadripolar coronary sinus pacing leads.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-03-25 DOI:10.1016/j.hrthm.2025.03.1979

Ethan S Wagner, Robert K Lewis, Sean D Pokorney, Donald D Hegland, Jonathan P Piccini

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引用次数: 0

Abstract

Background: Quadripolar coronary sinus (CS) leads are commonly employed to achieve left ventricular pacing. There are limited data on extraction of these leads relative to traditional unipolar or bipolar CS pacing leads.

Objective: The purpose of this study was to examine the safety and efficacy of quadripolar CS lead extraction and CS lead reimplantation and to compare outcomes with extraction of non-quadripolar CS leads.

Methods: Patients who underwent extraction of CS leads between 2013 and 2024 were included. Outcomes of interest were rates of complete CS lead removal, complete procedural success, major adverse events, and successful reimplantation in the CS.

Results: A total of 182 patients were included (102 quadripolar leads and 80 non-quadripolar leads). The mean age of the patients was 68.0 ± 11.6 years, and 22% were female. The mean CS lead age was significantly lower in the quadripolar group (3.0 ± 2.7 years vs 8.2 ± 4.3 years; P < .001). The complete procedural success rate was significantly higher in the quadripolar group (99% vs 90%; P = .01); there was no difference between groups after accounting for lead age. There was no significant difference in complete CS lead removal rates between groups (99% vs 95%; P = .17). Two major adverse events occurred in the non-quadripolar group and were directly related to lead extraction. In the quadripolar group, manual traction alone was successful in 59%, laser sheaths were used in 39%, and rotational cutting tools were used in 9%. In the non-quadripolar group, manual traction alone was successful in 19%, laser sheaths were used in 79%, and rotational cutting tools were used in 26%. There was no significant difference in reimplantation success rates between groups (82% vs 90%; P = .30).

Conclusion: Quadripolar CS lead extraction had a high success rate and low rate of major adverse events. Reimplantation in the CS was possible with a good success rate but was often limited by CS branch stenosis or occlusion.

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.