Background: Data on preferred ICD lead type and optimal RV lead position in patients undergoing CRT-D implantation are limited. Objectives: To compare dual- versus single-coil ICD leads and non-apical versus apical RV lead position and their impact on clinical parameters and survival in CRT-D recipients. Methods: A total of 563 consecutive patients with advanced heart failure and indication for CRT-D implantation were enrolled in two European tertiary centers. Endpoints were improvement in NYHA functional class, changes in echo- and electrocardiographic parameters, and all-cause and cardiovascular mortality. Results: In this retrospective analysis, a total of 313 (56%) dual- and 250 (44%) single-coil ICD leads were used. RV leads were placed non-apically in 262 (47%) and apically in 296 (53%) patients, respectively. Over a mean follow-up of 41 ± 34 months, all-cause mortality and cardiovascular mortality were similar for patients with dual- versus single-coil ICD lead (adjusted HR 0.81, 95% CI 0.58–1.12 and aHR 1.22, 95% CI 0.73–2.04) and non-apical versus apical RV lead position (aHR 0.98, 95% CI 0.71–1.36 and aHR 0.76, 95% CI 0.44–1.31). Non-apical RV lead position was associated with greater reduction in QRS duration after CRT implantation (− 14.4 ± 32.1 vs. − 4.3 ± 34.3 ms, p < 0.001). Conclusions: We found no association between ICD lead type or RV lead position and outcomes in CRT-D recipients. Non-apical RV lead position was associated with larger reduction in QRS duration.
- Dual coil
- Lead position
- Single coil
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine