Epicardial left ventricular leads via minimally invasive technique: a role of steroid eluting leads

J Cardiothorac Surg. 2017 Nov 8;12(1):95. doi: 10.1186/s13019-017-0659-4.

Abstract

Background: We retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads (steroid eluting vs. non-steroid eluting) in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance.

Methods: Between March 2008 and May 2014 an epicardial LV lead was implanted in 32 patients after failed transvenous LV lead placement using a left-sided lateral minithoracotomy or video-assisted thoracoscopy (mean age 64 ± 9 years). Patients were divided into two groups according to the type of implanted lead. Steroid eluting (SE) group: 21 patients (Myodex™ 1084 T; St. Jude Medical) and non-steroid eluting (NSE) group: 11 patients (MyoPore® 511,212; Greatbatch Medical).

Results: All epicardial leads could be placed successfully, without any intraoperative complications or mortality. With regard to the implanted lead following results were observed: sensing (mV): SE 8.8 ± 6.1 vs. NSE 10.1 ± 5.3 (p = 0.380); pacing threshold (V@0.5 ms): SE 1.0 ± 0.5 vs. NSE 0.9 ± 0.5 (p = 0.668); impedance (ohms): SE 687 ± 236 vs. NSE 790 ± 331 (p = 0.162). At the follow-up (2.6 ± 1.9 years) the following results were seen: sensing (mV): SE 8.7 ± 5.0 vs. NSE 11.2 ± 6.6 (p = 0.241), pacing threshold (V@0.5 ms): SE 1.4 ± 0.5 vs. NSE 1.0 ± 0.3 (p = 0.035), impedance (ohms): SE 381 ± 95 vs. NSE 434 ± 88 (p = 0.129).

Conclusions: Based on the results no strong differences have been found between the both types of epicardial LV leads (steroid eluting vs. non-steroid eluting) in CRT implantation in short- and midterm.

Keywords: Cardiac resynchronization therapy; Left ventricular lead; Minimally invasive; Non-steroid eluting lead; Steroid eluting lead.

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / therapy
  • Coated Materials, Biocompatible*
  • Electrodes, Implanted
  • Equipment Design
  • Female
  • Heart Failure / therapy*
  • Heart Ventricles / surgery*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Pacemaker, Artificial*
  • Retrospective Studies
  • Steroids / pharmacology*
  • Thoracotomy / methods*
  • Time Factors

Substances

  • Coated Materials, Biocompatible
  • Steroids