Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
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Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation. / Vogler, Julia; Geisler, Anne; Gosau, Nils; Hakmi, Samer; Willems, Stephan; Rassaf, Tienush; Wakili, Reza; Kaya, Elif.
In: SCI REP-UK, Vol. 8, No. 1, 07.12.2018, p. 17709.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation
AU - Vogler, Julia
AU - Geisler, Anne
AU - Gosau, Nils
AU - Hakmi, Samer
AU - Willems, Stephan
AU - Rassaf, Tienush
AU - Wakili, Reza
AU - Kaya, Elif
PY - 2018/12/7
Y1 - 2018/12/7
N2 - Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian vein approach (SV) in CRT implantations with respect to feasibility and safety. We performed a prospective cohort study enrolling twenty-four consecutive de-novo CRT implantations (group A) using a sCV at two centers. Fifty-four age-matched CRT patients implanted via the SV served (group B) as reference. Procedural success rate and complications were recorded during a follow-up of 4 weeks. All CRTs could be implanted in group A, with 91.7% using cephalic access alone. In group B, CRT implantation was successfully performed in 96.3%. Procedure and fluoroscopy duration were similar for both groups (sCV vs. SV: 119 ± 45 vs. 106 ± 31 minutes, 17 ± 9 vs 14 ± 9 minutes). Radiation dosage was higher in sCV group vs. SV (2984 ± 2370 vs. 1580 ± 1316 cGy*cm2; p = 0.001). There was no case of a pneumothorax in group of sCV, while two cases were observed using SV. Overall complication rate was similar (sCV: 13.0% vs. SV: 12.5%). de-novo CRT implantation using a triple cephalic vein approach is feasible. Procedure duration and complication rates were similar, while radiation dosage was higher in the sCV compared to the SV approach. Despite its feasibility in the clinical routine, controlled prospective studies with longer follow-up are required to elucidate a potential benefit with respect to lead longevity.
AB - Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian vein approach (SV) in CRT implantations with respect to feasibility and safety. We performed a prospective cohort study enrolling twenty-four consecutive de-novo CRT implantations (group A) using a sCV at two centers. Fifty-four age-matched CRT patients implanted via the SV served (group B) as reference. Procedural success rate and complications were recorded during a follow-up of 4 weeks. All CRTs could be implanted in group A, with 91.7% using cephalic access alone. In group B, CRT implantation was successfully performed in 96.3%. Procedure and fluoroscopy duration were similar for both groups (sCV vs. SV: 119 ± 45 vs. 106 ± 31 minutes, 17 ± 9 vs 14 ± 9 minutes). Radiation dosage was higher in sCV group vs. SV (2984 ± 2370 vs. 1580 ± 1316 cGy*cm2; p = 0.001). There was no case of a pneumothorax in group of sCV, while two cases were observed using SV. Overall complication rate was similar (sCV: 13.0% vs. SV: 12.5%). de-novo CRT implantation using a triple cephalic vein approach is feasible. Procedure duration and complication rates were similar, while radiation dosage was higher in the sCV compared to the SV approach. Despite its feasibility in the clinical routine, controlled prospective studies with longer follow-up are required to elucidate a potential benefit with respect to lead longevity.
KW - Aged
KW - Cardiac Resynchronization Therapy/methods
KW - Cardiac Resynchronization Therapy Devices
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Male
KW - Prospective Studies
KW - Prosthesis Implantation/methods
KW - Subclavian Vein/physiopathology
KW - Treatment Outcome
U2 - 10.1038/s41598-018-35994-0
DO - 10.1038/s41598-018-35994-0
M3 - SCORING: Journal article
C2 - 30532064
VL - 8
SP - 17709
JO - SCI REP-UK
JF - SCI REP-UK
SN - 2045-2322
IS - 1
ER -