de Maat Gijs E, Mulder Bart A, Van de Lande Martijn E, Rama Rajiv S, Rienstra Michiel, Mariani Massimo A, Maass Alexander H, Klinkenberg Theo J
Department of Cardio-Thoracic Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
J Clin Med. 2023 Sep 5;12(18):5766. doi: 10.3390/jcm12185766.
: to study the technical performance of epicardial left ventricular (LV) leads placed via video assisted thoracic surgery (VATS), compared to transvenously placed leads for cardiac resynchronization therapy (CRT). : From 2001 until 2013, a total of 644 lead placement procedures were performed for CRT. In the case of unsuccessful transvenous LV lead placement, the patient received an epicardial LV lead. Study groups consist of 578 patients with a transvenous LV lead and 66 with an epicardial LV lead. The primary endpoint was LV-lead failure necessitating a replacement or deactivation. The secondary endpoint was energy consumption. : The mean follow up was 5.9 years (epicardial: 5.5 ± 3.1, transvenous: 5.9 ± 3.5). Transvenous leads failed significantly more frequently than epicardial leads with a total of 66 (11%) in the transvenous leads group vs. 2 (3%) in the epicardial lead group ( = 0.037). Lead energy consumption was not significantly different between groups. : Epicardial lead placement is feasible, safe and shows excellent long-term performance compared to transvenous leads. Epicardial lead placement should be considered when primary transvenous lead placement fails or as a primary lead placement strategy in challenging cases.
研究经电视辅助胸腔镜手术（VATS）放置的心外膜左心室（LV）导线与经静脉放置的导线用于心脏再同步治疗（CRT）的技术性能。从2001年到2013年，共进行了644例导线植入手术用于CRT。在经静脉LV导线植入失败的情况下，患者接受心外膜LV导线植入。研究组包括578例经静脉LV导线患者和66例心外膜LV导线患者。主要终点是因LV导线故障需要更换或停用。次要终点是能量消耗。平均随访5.9年（心外膜：5.5±3.1，经静脉：5.9±3.5）。经静脉导线的故障率明显高于心外膜导线，经静脉导线组共66例（11%），心外膜导线组2例（3%）（P = 0.037）。两组之间的导线能量消耗无显著差异。与经静脉导线相比，心外膜导线植入可行、安全且显示出优异的长期性能。当首次经静脉导线植入失败时或在具有挑战性的病例中作为主要导线植入策略时，应考虑心外膜导线植入。
