Safety and performance of a novel defibrillation lead for left bundle branch area placement: primary results of the LEADR LBBAP clinical trial.

IF 5.7 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Pugazhendhi Vijayaraman, Xingbin Liu, Russell Denman, Edward J Schloss, Zachary I Whinnett, Jordana Kron, Marek Jastrzębski, John S Zakaib, Walter P Abhayaratna, François Philippon, Muhammad R Afzal, Parash Pokharel, James Burrell, Jocelyn Tanner, Tessa Geelen, Megan L Platner, Kiah Butler, Pamela K Mason, George H Crossley
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引用次数: 0

Abstract

Background: Right ventricular placement of the OmniaSecure defibrillation lead has demonstrated high defibrillation success and low occurrence of lead-related major complications. With the advent of left bundle branch area pacing (LBBAP) as a physiological pacing option, use of the OmniaSecure lead may be a viable alternative for LBBAP in the ICD population.

Objective: To understand the defibrillation efficacy at implant and safety of the OmniaSecure lead for LBBAP.

Methods: The global LEADR LBBAP trial enrolled patients indicated for de novo implantation of a primary or secondary prevention ICD or CRT-D. Per study protocol, LBBAP includes ECG characterization of LBBP and deep septal pacing. The primary efficacy objective was defibrillation efficacy at implant exceeding a pre-specified threshold of 88% in ≥160 patients. The primary safety endpoint was to demonstrate the OmniaSecure lead-related major complication rate at 3 months post-implant.

Results: A total of 307 patients underwent an LBBAP implant attempt (age: 64.9±12.2 years; 28.7% female; BMI: 28.4±6.1kg/m2). A total of 293 patients were successfully implanted per protocol (95.4%). The primary efficacy objective was met with 100% of patients defibrillated to protocol. The observed freedom from OmniaSecure lead-related major complications at 3 months was 97.9% (CI: 95.8-100%). There were zero study lead fractures, no oversensing adverse events and stable electrical parameters through 2.6±2.5 months follow-up.

Conclusions: These results demonstrate implantation of OmniaSecure lead when intended for LBBAP results in high defibrillation success at implant, stable short-term electrical parameters, and a low rate of OmniaSecure lead-related major complications at 3 months.

Clinical trial registration number: NCT04863664.

用于左束分支区域放置的新型除颤导线的安全性和性能:LEADR LBBAP临床试验的主要结果
背景:右心室放置OmniaSecure除颤导联显示出高的除颤成功率和低的导联相关主要并发症的发生率。随着左束分支起搏(LBBAP)作为一种生理起搏选择的出现,在ICD患者中,使用OmniaSecure导联可能是LBBAP的可行替代方案。目的:了解OmniaSecure引线用于LBBAP的除颤效果及安全性。方法:全球LEADR LBBAP试验纳入了需要重新植入一级或二级预防ICD或CRT-D的患者。根据研究方案,LBBAP包括LBBP和深间隔起搏的心电图特征。主要疗效目标是在≥160例患者中,移植物除颤疗效超过预定阈值88%。主要安全性终点是在植入物后3个月证明OmniaSecure铅相关的主要并发症发生率。结果:共有307例患者接受了LBBAP种植尝试(年龄:64.9±12.2岁,女性28.7%,BMI: 28.4±6.1kg/m2)。每个方案共成功植入293例(95.4%)。100%的患者按照方案进行了除颤,达到了主要疗效目标。观察到,3个月时OmniaSecure铅相关主要并发症的发生率为97.9% (CI: 95.8-100%)。在2.6±2.5个月的随访中,没有研究铅断裂,没有过度敏感的不良事件,电参数稳定。结论:这些结果表明,当用于LBBAP时,植入OmniaSecure导联可以获得高的除颤成功率,稳定的短期电参数,并且在3个月时OmniaSecure导联相关的主要并发症发生率低。临床试验注册号:NCT04863664。
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
Heart rhythm
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.
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