Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease

Amit Noheria, Martin Van Zyl, Luis Scott, Komandoor Srivathsan, Malini Madhavan, Samuel J Asirvatham, Christopher J. McLeod

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims To evaluate coronary sinus single-site (CS SS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CS SS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RV SS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CS CRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CS SS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7%) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3%) was extracted for unrelated reasons. Compared to CS SS leads, the lead revision/abandonment was similar with RV SS leads (Hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.03, 22.0), but was higher with CS CRT leads (HR 7.41, 95% CI 1.30, 139.0). There was no difference in change in LVEF between CS SS and RV SS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CS CRT group (11.2 ± 16.5%, P = 0.002). Fluoroscopy times were longer during implantation of CS SS compared to RV SS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). Conclusion In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing.

Original languageEnglish (US)
Pages (from-to)636-642
Number of pages7
JournalEuropace
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Tricuspid Valve
Coronary Sinus
Stroke Volume
Cardiac Resynchronization Therapy
Confidence Intervals
Fluoroscopy

Keywords

  • Coronary sinus pacing
  • Electrical dyssynchrony
  • Pacemaker
  • Tricuspid valve disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease. / Noheria, Amit; Van Zyl, Martin; Scott, Luis; Srivathsan, Komandoor; Madhavan, Malini; Asirvatham, Samuel J; McLeod, Christopher J.

In: Europace, Vol. 20, No. 4, 01.04.2018, p. 636-642.

Research output: Contribution to journalArticle

Noheria, Amit ; Van Zyl, Martin ; Scott, Luis ; Srivathsan, Komandoor ; Madhavan, Malini ; Asirvatham, Samuel J ; McLeod, Christopher J. / Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease. In: Europace. 2018 ; Vol. 20, No. 4. pp. 636-642.
@article{58a6ff997b904e6c88787e55d8932030,
title = "Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease",
abstract = "Aims To evaluate coronary sinus single-site (CS SS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CS SS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RV SS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CS CRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CS SS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7{\%}) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3{\%}) was extracted for unrelated reasons. Compared to CS SS leads, the lead revision/abandonment was similar with RV SS leads (Hazard ratio (HR) 0.87, 95{\%} confidence interval (CI) 0.03, 22.0), but was higher with CS CRT leads (HR 7.41, 95{\%} CI 1.30, 139.0). There was no difference in change in LVEF between CS SS and RV SS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CS CRT group (11.2 ± 16.5{\%}, P = 0.002). Fluoroscopy times were longer during implantation of CS SS compared to RV SS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). Conclusion In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing.",
keywords = "Coronary sinus pacing, Electrical dyssynchrony, Pacemaker, Tricuspid valve disease",
author = "Amit Noheria and {Van Zyl}, Martin and Luis Scott and Komandoor Srivathsan and Malini Madhavan and Asirvatham, {Samuel J} and McLeod, {Christopher J.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1093/europace/euw422",
language = "English (US)",
volume = "20",
pages = "636--642",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease

AU - Noheria, Amit

AU - Van Zyl, Martin

AU - Scott, Luis

AU - Srivathsan, Komandoor

AU - Madhavan, Malini

AU - Asirvatham, Samuel J

AU - McLeod, Christopher J.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Aims To evaluate coronary sinus single-site (CS SS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CS SS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RV SS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CS CRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CS SS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7%) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3%) was extracted for unrelated reasons. Compared to CS SS leads, the lead revision/abandonment was similar with RV SS leads (Hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.03, 22.0), but was higher with CS CRT leads (HR 7.41, 95% CI 1.30, 139.0). There was no difference in change in LVEF between CS SS and RV SS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CS CRT group (11.2 ± 16.5%, P = 0.002). Fluoroscopy times were longer during implantation of CS SS compared to RV SS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). Conclusion In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing.

AB - Aims To evaluate coronary sinus single-site (CS SS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CS SS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RV SS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CS CRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CS SS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7%) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3%) was extracted for unrelated reasons. Compared to CS SS leads, the lead revision/abandonment was similar with RV SS leads (Hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.03, 22.0), but was higher with CS CRT leads (HR 7.41, 95% CI 1.30, 139.0). There was no difference in change in LVEF between CS SS and RV SS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CS CRT group (11.2 ± 16.5%, P = 0.002). Fluoroscopy times were longer during implantation of CS SS compared to RV SS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). Conclusion In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing.

KW - Coronary sinus pacing

KW - Electrical dyssynchrony

KW - Pacemaker

KW - Tricuspid valve disease

UR - http://www.scopus.com/inward/record.url?scp=85045881166&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045881166&partnerID=8YFLogxK

U2 - 10.1093/europace/euw422

DO - 10.1093/europace/euw422

M3 - Article

C2 - 28339945

AN - SCOPUS:85045881166

VL - 20

SP - 636

EP - 642

JO - Europace

JF - Europace

SN - 1099-5129

IS - 4

ER -