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Long‐Term Performance of the Attain Model 4193 Left Ventricular Lead
Author(s) -
JOHNSON W. BEN,
ABRAHAM WILLIAM T.,
YOUNG JAMES B.,
WHEELAN KEVIN,
SMITH ANDREW L.,
CHANG YANPING,
BRINKMAN PAULA
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02451.x
Subject(s) - medicine , cardiac resynchronization therapy , lead (geology) , implant , cardiology , adverse effect , implantable cardioverter defibrillator , heart failure , surgery , ejection fraction , geomorphology , geology
Background: Cardiac resynchronization therapy (CRT) has proven to be a valuable therapy addition for patients with drug‐refractory heart failure and a ventricular conduction delay. Delivery of CRT is dependent upon the successful implantation and chronic performance of a left ventricular (LV) pacing lead. This study assessed the long‐term electrical performance and safety of a steroid‐eluting, transvenous, over‐the‐wire, cardiac vein pacing lead.Methods: The Attain Model 4193 LV lead (Medtronic, Inc, Minneapolis MN, USA) was successfully implanted in 1,070 patients with 286 patients completing 3 years of follow‐up. Clinical data were collected at pre‐implant, implant, and at 6‐month intervals for 3 years.Results: Over 3 years, the mean chronic pacing threshold ranged from 1.9 V to 2.1 V, the mean R‐wave sensing amplitudes ranged between 13.6 mV and 15.0 mV, and the mean pacing impedance ranged between 562 ohms and 590 ohms. Additionally, the observed freedom from first post‐implant LV‐lead‐related complications was 90.4%. Of 1,070 total patients, 82 experienced 89 LV‐lead‐related adverse events requiring invasive interventions or resulting in the termination of the CRT therapy. The LV lead was repositioned in 31 patients, replaced in 21 patients, and explanted/capped in four patients. There were no deaths related to the LV lead during implantation or during the follow‐up period.Conclusions: The data suggest that the 4193 LV lead is safe and effective over time. The LV lead electrical measurements remained stable through follow‐up, demonstrating reliable long‐term performance within the recommended value range at 36 months and had an acceptable complication rate.