Heart rhythm : the official journal of the Heart Rhythm Society
-
Transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy-defibrillator (CRT-D) delivery is unsuccessful in 8% to 10% of cases. These patients might benefit from an epicardial lead. However, data on long-term epicardial lead performance are scarce. Furthermore, extracting an epicardial lead requires a rethoracotomy. ⋯ This study demonstrates that epicardial LV leads have an excellent long-term performance. Partially retaining the lead after device infection was associated with a risk of reinfection with limited long-term clinical implications for the patient.
-
Predictors of torsades de pointes (TdP) in bradyarrhythmia-induced acquired long QT syndrome are not well defined. ⋯ An algorithm combining specific T-wave morphologies was useful for identifying patients with AVB who are at risk for developing TdP.
-
Multicenter Study
Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.
Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. ⋯ Providing programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks.
-
Multiple cardiac operations and resultant myocardial scarring have been implicated in the overall reduced performance of epicardial pacing systems in patients with congenital heart disease (CHD). ⋯ Epicardial leads had acceptable longevity despite cardiac operations for complex CHD, suggesting the long-term reliability of this pacing method.
-
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.