Quadripolar versus bipolar leads in cardiac resynchronization therapy: An analysis of the National Cardiovascular Data Registry.
| Title: | Quadripolar versus bipolar leads in cardiac resynchronization therapy: An analysis of the National Cardiovascular Data Registry. |
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| Authors: | Hakemi EU; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Division of Cardiology, Cook County Health and Hospitals System, Chicago, Illinois.; Doukky R; Division of Cardiology, Cook County Health and Hospitals System, Chicago, Illinois.; Parzynski CS; Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, Connecticut.; Curtis JP; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.; Madias C; The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts. Electronic address: cmadias@tuftsmedicalcenter.org. |
| Source: | Heart rhythm [Heart Rhythm] 2020 Jan; Vol. 17 (1), pp. 81-89. Date of Electronic Publication: 2019 Jul 29. |
| Publication Type: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c2004- |
| MeSH Terms: | Electrodes, Implanted* ; Registries*; Cardiac Resynchronization Therapy/*methods ; Heart Failure/*therapy; Aged ; Equipment Design ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Treatment Outcome |
| Abstract: | Background: The introduction of quadripolar (QP) cardiac resynchronization therapy (CRT) leads aimed to improve procedural and clinical outcomes.; Objective: The National Cardiovascular Data Registry was analyzed to characterize the use as well as the procedural and clinical outcomes of QP leads in comparison with unipolar and bipolar (BP) leads.; Methods: We evaluated data on 175,684 procedures reported between September 1, 2010, and December 31, 2015. Clinical outcomes were analyzed using Centers for Medicare & Medicaid Services claims data.; Results: Among all CRT device implants, there was a drop in reported lead placement failure from 6.04% to 5.21% (P < .0001 for trend) and a drop in the reported diaphragmatic stimulation rates from 0.07% to 0.01% (P < .007 for trend) between the last quarters of 2010 and 2015. No significant difference in procedural complication rates between QP and BP leads occurred (1.34% and 1.39%, respectively; P = .50). Among patients linked to Centers for Medicare & Medicaid Services claims data, no statistically significant difference in the combined primary outcome of death, congestive heart failure admission, device malfunction, and reoperation between BP and QP leads was observed (34.15 and 34.19 events per 100 patient-years, respectively; P = .89).; Conclusion: Since the introduction of QP leads, there was a reduction in CRT lead placement failure rates and a reduction in diaphragmatic stimulation rates. However, no statistically significant difference in long-term clinical outcomes between BP and QP leads was observed in elderly patients undergoing CRT implantation.; (Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Biventricular pacing; Cardiac resynchronization therapy; Congestive heart failure; Left ventricular lead; Quadripolar lead |
| Entry Date(s): | Date Created: 20190802 Date Completed: 20210302 Latest Revision: 20210302 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.hrthm.2019.07.028 |
| PMID: | 31369870 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't