A survival analysis of bipolar steroid-eluting and unipolar nonsteroid-eluting epicardial leads.
bipolar leads
bipolar pacemakers
epicardial pacemakers
pacemaker
steroid-eluting leads
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
revised:
20
09
2022
received:
13
04
2022
accepted:
12
10
2022
pubmed:
18
10
2022
medline:
18
1
2023
entrez:
17
10
2022
Statut:
ppublish
Résumé
Epicardial pacemakers are known as an alternative for endocardial pacemakers in some cases such as heart block, and complex congenital heart diseases. Considering recent advances and improvement of epicardial lead subtypes, it is essential to investigate the long-term function of them. In this study, we aimed to assess the sensing and pacing characteristics, and survival of bipolar steroid-eluting and unipolar nonsteroid-eluting epicardial pacemakers. We conducted an entirely concentrated search on the documents of all patients who had undergone epicardial lead implantation in the Shaheed Rajaie Cardiovascular, Medical & Research Center during 2015-2018. Implant, and follow-up data were extracted. Kaplan-Meier analysis and Weibull regression hazards model were applied for the survival analysis. Eighty-nine leads were implanted for 77 patients. Of the total leads, 52.81%, 53.93%, and 47.19% were implanted in children (under 18-year-old), females, and patients with congenital heart diseases, respectively. Bipolar steroid-eluting leads comprised 33.71% of 89 leads. The pacing threshold of unipolar nonsteroid-eluting leads that were implanted on the left ventricle and right atrium increased significantly during the follow-up to greater records than bipolar steroid-eluting leads. Survival analysis also revealed that bipolar steroid-eluting leads are significantly better in 48-month survival (Weibull hazard ratio [HR]: 0.13 (95% confidence interval [CI]: 0.02-0.99), p = .049). Age, ventricular location of the lead, and acute pacing characteristics were not associated with survival. Bipolar steroid-eluting epicardial leads have an acceptable survival compared with unipolar nonsteroid-eluting, without a significant difference regarding patients age. Therefore, they could be an excellent alternative for endocardial ones.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
209-218Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Cohen MI, Bush DM, Vetter VL, et al. Permanent epicardial pacing in pediatric patients: seventeen years of experience and 1200 outpatient visits. Circulation. 2001;103(21):2585-2590.
Tomaske M, Gerritse B, Kretzers L, et al. A 12-year experience of bipolar steroid-eluting epicardial pacing leads in children. Ann Thorac Surg. 2008;85(5):1704-1711.
Ten Cate FU. Endocardial and epicardial steroid lead pacing in the neonatal and paediatric age group. Heart. 2002;88(4):392-396.
Gras D, Böcker D, Lunati M, et al. Implantation of cardiac resynchronization therapy systems in the CARE-HF trial: procedural success rate and safety. Europace. 2007;9(7):516-522.
Ahsan SY, Saberwal B, Lambiase PD, et al. An 8-year single-centre experience of cardiac resynchronisation therapy: procedural success, early and late complications, and left ventricular lead performance. Europace. 2013;15(5):711-717.
Tantengco MVT, Thomas RL, Karpawich PP. Left ventricular dysfunction after long-term right ventricular apical pacing in the young. J Am Coll Cardiol. 2001;37(8):2093-2100.
Walsh EP, Cecchin F. Recent advances in pacemaker and implantable defibrillator therapy for young patients. Curr Opin Cardiol. 2004;19(2):91-96.
Bauersfeld U, Nowak B, Molinari L, et al. Low-energy epicardial pacing in children: the benefit of autocapture. Ann Thorac Surg. 1999;68(4):1380-1383.
Goel MK, Khanna P, Kishore J. Understanding survival analysis: Kaplan-Meier estimate. Int J Ayurveda Res. 2010;1(4):274-278.
Mohari N, Starr JP, Gates RN, Domico MB, Batra AS. Bipolar versus unipolar temporary epicardial ventricular pacing leads use in congenital heart disease: a prospective randomized controlled study. Pacing Clin Electrophysiol. 2016;39(5):471-477.
Yiu P, Tansley P, Pepper JR. Improved reliability of post-operative ventricular pacing by use of bipolar temporary pacing leads. Cardiovasc Surg. 2001;9(4):391-395.
Radovsky AS, Van Vleet JF. Effects of dexamethasone elution on tissue reaction around stimulating electrodes of endocardial pacing leads in dogs. Am Heart J. 1989;117(6):1288-1298.
MONO HG, STOKES KB. The electrode-tissue interface: the revolutionary role of steroid elution. Pacing Clin Electrophysiol. 1992;15(1):95-107.
Fortescue EB, Berul CI, Cecchin F, Walsh EP, Triedman JK, Alexander ME. Patient, procedural, and hardware factors associated with pacemaker lead failures in pediatrics and congenital heart disease. Heart Rhythm. 2004;1(2):150-159.
McLeod CJ, Attenhofer Jost CH, Warnes CA, et al. Epicardial versus endocardial permanent pacing in adults with congenital heart disease. J Interv Card Electrophysiol. 2010;28(3):235-243.
Beurskens N, Breeman K, Dasselaar KJ, et al. Leadless cardiac pacing systems: current status and future prospects. Expert Rev Med Devices. 2019;16(11):923-930.