scholarly journals Single-Pass VDD Pacing Lead for Cardiac Resynchronization Therapy: A Reliable Alternative

Micromachines ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 978
Author(s):  
Silvius-Alexandru Pescariu ◽  
Raluca Şoşdean ◽  
Bogdan Enache ◽  
Răzvan I. Macarie ◽  
Mariana Tudoran ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Complication Rate ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Venous Anatomy ◽  
Safe Alternative ◽  
Functional Parameters ◽  
Lower Complication ◽  
Pacing Lead ◽  
Group B

(1) Background: Cardiac resynchronization therapy (CRT) systems can be simplified by excluding the atrial lead and using a Ventricular-Dual-Dual (VDD) pacing lead. Possible disadvantages might include atrial undersensing and Ventricular-Ventricular-Inhibition (VVI) pacing. Because literature data concerning these systems are scarce, we analyzed their benefits and technical safety. (2) Methods: this retrospective study compared 50 patients implanted with VDD–CRT systems (group A), mainly because of unfavorable venous anatomy concerning the complication rate, with 103 subjects with Dual-Dual-Dual (DDD)–CRT systems (group B) implanted during 2000–2016 and 49 (group C) during 2016–2020. To analyze the functional parameters of the devices, we selected subgroups of 27 patients (subgroup A) and 47 (subgroup B) patients with VDD–CRT in 2000–2016, and 36 subjects (subgroup C) with DDD–CRT implanted were selected in 2017–2020. (3) Results: There was a trend of a lower complication rate with VDD–CRT systems, especially concerning infections during 2000–2016 (p = 0.0048), but similar results were obtained after rigorous selection of patients and employment of an upgraded design of devices/leads. With a proper device programing, CRT pacing had similar results, atrial undersensing being minimal (p = 0.65). For VDD-systems, VVI pacing was recorded only 1.7 ± 2.24% of the time. (4) Conclusions: In patients with a less favorable venous anatomy, VDD–CRT systems may represent a safe alternative regarding complications rates and functional parameters.

Variability of coronary venous anatomy in patients undergoing cardiac resynchronization therapy: A high-speed rotational venography study

Heart Rhythm ◽  
2007 ◽  
Vol 4 (9) ◽  
pp. 1155-1162 ◽  
Author(s):  
Dan Blendea ◽  
Ravi V. Shah ◽  
Angelo Auricchio ◽  
Veena Nandigam ◽  
Mary Orencole ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
High Speed ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Venous Anatomy

Cardiac resynchronization therapy: selection of candidates

2015 ◽  
pp. 405-419
Author(s):  
Victoria Delgado ◽  
Jeroen J. Bax
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Left Ventricular ◽  
Myocardial Scar ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Resynchronization Therapy ◽  
Venous Anatomy ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Mechanics ◽  
Selection Of

Cardiac resynchronization therapy (CRT) is an established treatment for heart failure patients who remain symptomatic despite optimal medical treatment, with left ventricular ejection fraction <35% and QRS complex with left bundle branch block morphology or duration ≥150 ms. Non-invasive imaging modalities contribute in the evaluation and selection of patients who are candidates for CRT. Evaluation of left ventricular mechanics and dyssynchrony, extent and location of myocardial scar and cardiac venous anatomy are important to estimate the likelihood of favourable response to CRT. This chapter will review the ‘why and how’ to assess cardiac dyssynchrony, myocardial scar, and cardiac venous anatomy, prior to CRT implantation.

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