Heart rhythm : the official journal of the Heart Rhythm Society
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A minority of patients undergoing cardiac resynchronization therapy (CRT) use a surgically placed epicardial left ventricular (SPELV) pacing lead. Previous studies of outcomes in patients receiving such leads have been limited to small cohorts with limited follow-up. ⋯ Patients undergoing epicardial LV lead placement using a surgical approach have outcomes and rates of reverse ventricular remodeling similar to those in patients undergoing LV lead placement using a percutaneous approach.
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Comparative Study
Transvenous extraction profile of Riata leads: procedural outcomes and technical complexity of mechanical removal.
Riata (RT) and Sprint Fidelis (SF) leads were recalled by the United States Food and Drug Administration because of an increased rate of failure mainly due to conductor fracture or insulation abrasion. According to lead design and type of failure, extraction complexity may be different, potentially affecting procedural outcomes and indications. ⋯ Extraction of RT leads is feasible and effective. However, extraction of RT leads is more complex than that of SF leads. Lack of coil backfilling and cable externalization in RT group may account for these differences.
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Magnetic resonance imaging (MRI) has been safely performed in some patients with cardiac implantable electronic devices (CIEDs) under careful monitoring and prespecified conditions. Pacemaker-dependent patients are often excluded, partly because of the potential for "power-on reset" (PoR), which can lead to a change from asynchronous to inhibited pacing with consequent inhibition of pacing due to electromagnetic interference during MRI. ⋯ PoR occurs infrequently but can cause deleterious changes in pacing mode and heart rate. MRI should not be performed in pacemaker-dependent patients with older at-risk generators. Continuous monitoring during MRI is essential because unrecognized PoR may inhibit pacing or accelerate battery depletion due to high pacing output.