| Long-term outcome of leads and patients following robotic epicardial left ventricular lead placement for cardiac resynchronization therapy. | |
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MedLine Citation:
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PMID: 21029136 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Introduction: In cardiac resynchronization therapy (CRT), positive clinical response and reverse remodeling have been reported using robotically assisted left ventricular (LV) epicardial lead placement. However, the long-term performance of epicardial leads and long-term outcome of patients who undergo CRT via robotic assistance are unknown. In addition, since the LV lead placement is more invasive than a transvenous procedure, it is important to identify patients at higher risk of complications. Methods: We evaluated 78 consecutive patients (70 ± 11 years, 50 male) who underwent robotic epicardial LV lead placement. The short- (<12 months) and long-term (≥12 months) lead performance was determined through device interrogations. Mortality data were determined by contact with the patient's family and referring physicians and confirmed using the Social Security Death Index. Results: All patients had successful lead placement and were discharged in stable condition. When compared to the time of implantation, there was a significant increase in pacing threshold (1.0 ± 0.5 vs 2.14 ± 1.2; P < 0.001) and decrease in lead impedance (1010 ± 240 Ω vs 491 ± 209 Ω; P < 0.001) at short-term follow-up. The pacing threshold (2.3 ± 1.2 vs 2.14 ± 1.2; P = 0.30) and lead impedance (451 ± 157 Ω vs 491 ± 209 Ω; P = 0.10) remained stable during long-term follow-up when compared to short-term values. At a follow-up of 44 ± 21 months, there were 20 deaths (26%). These patients were older (77 ± 7 vs 67 ± 11 years; P = 0.001) and had a lower ejection fraction (EF) (13 ± 7% vs 18 ± 9%; P = 0.02) than surviving patients. Conclusion: Robotically implanted epicardial LV leads for CRT perform well over short- and long-term follow-up. Older patients with a very low EF are at higher risk of death. The risks and benefits of this procedure should be carefully considered in these patients. (PACE 2011; 34:235-240). |
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Authors:
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Ganesh S Kamath; Sandhya Balaram; Andrew Choi; Olga Kuteyeva; Naga Vamsi Garikipati; Jonathan S Steinberg; Suneet Mittal |
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Publication Detail:
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Type: Journal Article Date: 2010-10-28 |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 34 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 235-40 Citation Subset: IM |
Copyright Information:
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©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc. |
Affiliation:
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Al-Sabah Arrhythmia Institute and Division of Cardiology, Division of Cardiothoracic Surgery, St. Luke's and Roosevelt Hospitals, Columbia University College of Physicians & Surgeons, New York, New York. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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