ICD lead type and RV lead position in CRT-D recipients

Alexander P. Benz, Mate Vamos, Julia W. Erath, Peter Bogyi, G. Duray, Stefan H. Hohnloser

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalClinical Research in Cardiology
DOIs
Publication statusAccepted/In press - May 24 2018

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Mortality
Lead
Heart Failure
Survival

Keywords

  • Apical
  • CRT
  • Dual coil
  • Lead position
  • Septal
  • Single coil

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Benz, A. P., Vamos, M., Erath, J. W., Bogyi, P., Duray, G., & Hohnloser, S. H. (Accepted/In press). ICD lead type and RV lead position in CRT-D recipients. Clinical Research in Cardiology, 1-9. https://doi.org/10.1007/s00392-018-1286-3

ICD lead type and RV lead position in CRT-D recipients. / Benz, Alexander P.; Vamos, Mate; Erath, Julia W.; Bogyi, Peter; Duray, G.; Hohnloser, Stefan H.

In: Clinical Research in Cardiology, 24.05.2018, p. 1-9.

Research output: Contribution to journalArticle

Benz, Alexander P. ; Vamos, Mate ; Erath, Julia W. ; Bogyi, Peter ; Duray, G. ; Hohnloser, Stefan H. / ICD lead type and RV lead position in CRT-D recipients. In: Clinical Research in Cardiology. 2018 ; pp. 1-9.
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abstract = "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.",
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AU - Benz, Alexander P.

AU - Vamos, Mate

AU - Erath, Julia W.

AU - Bogyi, Peter

AU - Duray, G.

AU - Hohnloser, Stefan H.

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N2 - 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.

AB - 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.

KW - Apical

KW - CRT

KW - Dual coil

KW - Lead position

KW - Septal

KW - Single coil

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