Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy
Background: When conventional trans-venous CS lead placement fails, trans-septal endocardial left ventricle lead placement is an alternative technique used to capture the left ventricle endocardially; however, its use is limited due to a lack of evidence, practice uptake, and clinical trials. Method...
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MDPI AG
2024-11-01
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| Online Access: | https://www.mdpi.com/2227-9059/12/12/2693 |
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| author | Arsalan Farhangee Mark J. Davies Katie Gaughan Mihai Mesina Ion Mîndrilă |
| author_facet | Arsalan Farhangee Mark J. Davies Katie Gaughan Mihai Mesina Ion Mîndrilă |
| author_sort | Arsalan Farhangee |
| collection | DOAJ |
| description | Background: When conventional trans-venous CS lead placement fails, trans-septal endocardial left ventricle lead placement is an alternative technique used to capture the left ventricle endocardially; however, its use is limited due to a lack of evidence, practice uptake, and clinical trials. Methods: In this single-center cohort study, we evaluated the efficiency of the procedure, post-procedural complication rate, rate of thromboembolic events, overall survival rate, and changes in the echocardiographic parameters, brain natriuretic peptide (BNP) level, and New York Heart Association (NYHA) class, both before and after TSLV lead implantation. Results: The TSLV lead implant is safe and improves EF, LVEDV, LVESV, and LVIDd. It significantly reduces the NTproBNP levels and the NYHA class; however, the rate of stroke incidence remains high, at 9%. Conclusions: We demonstrated a high success rate of trans-septal left ventricular endocardial lead implantation, LV reverse remodeling was noted, and patients had a favorable clinical response; however, there was an increased risk of systemic embolization after the trans-septal LV lead implant. |
| format | Article |
| id | doaj-art-4dfb8f8ef8eb401593986ed667d67fbb |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-4dfb8f8ef8eb401593986ed667d67fbb2024-12-27T14:12:32ZengMDPI AGBiomedicines2227-90592024-11-011212269310.3390/biomedicines12122693Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus AnatomyArsalan Farhangee0Mark J. Davies1Katie Gaughan2Mihai Mesina3Ion Mîndrilă4Department of Cardiology, Milton Keynes University Hospital, Milton Keynes MK6 5LD, UKDepartment of Cardiology, Milton Keynes University Hospital, Milton Keynes MK6 5LD, UKDepartment of Cardiology, United Lincolnshire NHS Trust, Lincoln County Hospital, Lincoln LN2 5QY, UKDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaBackground: When conventional trans-venous CS lead placement fails, trans-septal endocardial left ventricle lead placement is an alternative technique used to capture the left ventricle endocardially; however, its use is limited due to a lack of evidence, practice uptake, and clinical trials. Methods: In this single-center cohort study, we evaluated the efficiency of the procedure, post-procedural complication rate, rate of thromboembolic events, overall survival rate, and changes in the echocardiographic parameters, brain natriuretic peptide (BNP) level, and New York Heart Association (NYHA) class, both before and after TSLV lead implantation. Results: The TSLV lead implant is safe and improves EF, LVEDV, LVESV, and LVIDd. It significantly reduces the NTproBNP levels and the NYHA class; however, the rate of stroke incidence remains high, at 9%. Conclusions: We demonstrated a high success rate of trans-septal left ventricular endocardial lead implantation, LV reverse remodeling was noted, and patients had a favorable clinical response; however, there was an increased risk of systemic embolization after the trans-septal LV lead implant.https://www.mdpi.com/2227-9059/12/12/2693cardiac resynchronization therapytrans-septal LV leadheart failurequality of life |
| spellingShingle | Arsalan Farhangee Mark J. Davies Katie Gaughan Mihai Mesina Ion Mîndrilă Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy Biomedicines cardiac resynchronization therapy trans-septal LV lead heart failure quality of life |
| title | Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy |
| title_full | Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy |
| title_fullStr | Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy |
| title_full_unstemmed | Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy |
| title_short | Observational Study of Trans-Septal Endocardial Left Ventricle Lead Implant for Effective Cardiac Resynchronization Therapy in Patients with Heart Failure and Challenging Coronary Sinus Anatomy |
| title_sort | observational study of trans septal endocardial left ventricle lead implant for effective cardiac resynchronization therapy in patients with heart failure and challenging coronary sinus anatomy |
| topic | cardiac resynchronization therapy trans-septal LV lead heart failure quality of life |
| url | https://www.mdpi.com/2227-9059/12/12/2693 |
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