Procedural Success of Left Ventricular Lead Placement for Cardiac Resynchronization Therapy: A Meta-Analysis

JACC. Clinical Electrophysiology
James Hugo Phillimore GambleTimothy Rider Betts

Abstract

The goal of this study was to assess the contemporary and historical success rates of transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy (CRT), their change over time, and the reasons for failure. In selected patients, CRT improves morbidity and mortality, but the placement of the LV lead can be technically challenging. A literature search was used to identify all studies reporting success rates of LV lead placement for CRT via the coronary sinus (CS) route. A total of 164 studies were identified, and a meta-analysis was performed. The studies included 29,503 patients: 74% (95% confidence interval [CI]: 72% to 76%) were male; their mean age was 66 years (95% CI: 65 to 67); their mean New York Heart Association functional class was 2.8 (95% CI: 2.7 to 2.9); the mean LV ejection fraction was 26% (95% CI: 25% to 28%); and the mean QRS duration was 155 ms (95% CI: 150 to 160). The overall rate of failure of implantation of an LV lead was 3.6% (95% CI: 3.1 to 4.3). The rate of failure in studies commencing before 2005 was 5.4% (95% CI: 4.4% to 6.5%), and from 2005 onward it was 2.4% (95% CI: 1.9% to 3.1%; p < 0.001). Causes of failure (reported for 39% of failures) also changed over time. Failure ...Continue Reading

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Citations

Dec 21, 2018·Pacing and Clinical Electrophysiology : PACE·Juan J García GuerreroAntonio Merchán Herrera
Apr 15, 2020·Pacing and Clinical Electrophysiology : PACE·Zak LoringBrett D Atwater
May 4, 2020·Pacing and Clinical Electrophysiology : PACE·Christophe GarwegRik Willems
Jan 12, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·James Hugo Phillimore GambleTimothy Rider Betts
Aug 26, 2018·Heart Failure Reviews·Benjamin J SieniewiczChristopher A Rinaldi
Nov 14, 2020·Pacing and Clinical Electrophysiology : PACE·László HejjelAttila Kónyi
Jul 3, 2021·Pacing and Clinical Electrophysiology : PACE·Kazuto HayasakaTetsuo Sasano

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Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
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