Implantation of cardiac resynchronization therapy systems in the CARE-HF trial: procedural success rate and safety.

Details

Serval ID
serval:BIB_3B10C7CE6F41
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Implantation of cardiac resynchronization therapy systems in the CARE-HF trial: procedural success rate and safety.
Journal
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
Author(s)
Gras D., Böcker D., Lunati M., Wellens H.J., Calvert M., Freemantle N., Gervais R., Kappenberger L., Tavazzi L., Erdmann E., Cleland J.G., Daubert J.C.
Working group(s)
CARE-HF Study Steering Committee, Investigators
ISSN
1099-5129 (Print)
ISSN-L
1099-5129
Publication state
Published
Issued date
2007
Volume
9
Number
7
Pages
516-522
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
AIMS: To assess procedural characteristics and adjudicated procedure-related (<or=30 days) major adverse events among patients who underwent cardiac resynchronization therapy (CRT) implantation in the CARE-HF study. The CARE-HF study shows that CRT improves symptoms and reduces morbidity and mortality in New York Heart Association (NYHA) class III/IV chronic heart failure (CHF) patients. However, safe and proper implantation of pacing systems remains key to effective CRT delivery.
METHODS AND RESULTS: Generalized linear modeling was used to examine the relationships between first implant success/failure and: NYHA class; beta-adrenergic blocker use; underlying ischemic vs. non-ischemic heart disease; history of coronary artery bypass graft or valve surgery; left ventricular (LV) end-diastolic volume<or=vs. >300 cm(3); and, influence of the participating study-centres. Implantation was attempted in 404/409 patients assigned to CRT, and in 65/404 patients assigned to medical therapy. Among these 469 patients, 450 (95.9%) received a successfully implanted and activated device. Complications occurred within 24 h in 47 patients (10.0%), mainly lead dislodgments (n = 10, 2.1%) and coronary sinus dissection/perforation (n = 10, 2.1%), and between 24 h and 30 days in 26 patients (5.5%), mainly lead dislodgment (n = 13, 2.8%). Mean LV lead stimulation threshold was significantly higher than at the right atrium or right ventricle, though remained stable, delivering effective, and reliable CRT. Implanting experience was the only predictor of procedural outcome.
CONCLUSION: Transvenous CRT system implantation, using a CS lead designed for long-term LV pacing, was safe and reliable. As implanting centres become more experienced, this success rate is expected to increase further.
Keywords
Aged, Cardiac Pacing, Artificial/adverse effects, Cardiac Pacing, Artificial/mortality, Defibrillators, Implantable, Female, Heart Failure/mortality, Heart Failure/therapy, Humans, Male, Middle Aged, Pacemaker, Artificial, Postoperative Complications, Survival Analysis, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
15/02/2008 11:28
Last modification date
20/08/2019 13:30
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