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Initial Experience of Pacing with a Lumenless Lead System in Patients with Congenital Heart Disease
Author(s) -
CHAKRABARTI SANTABHANU,
MORGAN GARETH J.,
KENNY DAMIEN,
WALSH KEVIN P.,
OSLIZLOK PAUL,
MARTIN ROBIN P.,
TURNER MARK S.,
STUART A. GRAHAM
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.1540-8159.2009.02487.x
Subject(s) - medicine , lead (geology) , atrioventricular block , heart disease , surgery , cardiac resynchronization therapy , cardiology , retrospective cohort study , ventricular pacing , heart failure , ejection fraction , geomorphology , geology
Background: Long‐term pacing is frequently necessary in patients with congenital heart disease (CHD). Preservation of ventricular function and avoidance of venous occlusion is important in these patients. Site‐selective pacing with a smaller diameter lead is achievable with the model 3830 lead (SelectSecure®, Medtronic Inc., Minneapolis, MN, USA), which was specifically designed to target these complications. We describe our initial experience with the Model 3830 lead in patients with CHD.Methods: Retrospective analysis of all patients undergoing site‐selective implantation of a Model 3830 lead(s) from two congenital heart centers (Bristol, UK, and Dublin, Ireland) from October 2004 until February 2008.Results: We implanted 139 SelectSecure® leads (atrial n = 70; ventricular n = 69) in 90 patients (57 male) with CHD. Median age at implantation: 13.4 years (1.1–59.2 years), median weight: 43 kg. Sixty‐nine patients (76%) were children (<18 years). Indications for lead implantation included atrioventricular block (n = 55), sinus node disease (n = 18), implantable cardiac defibrillator (n = 12), antitachycardia pacing (n = 4), and cardiac resynchronization (n = 1). Twenty‐two patients underwent pre‐existing lead extraction during the same procedure. All the attempted procedures resulted in successful pacing. One patient had a significantly raised threshold at implantation. There was no procedural mortality. There were two procedural complications. Three patients required lead repositioning for increasing thresholds early postprocedure (<6 weeks). Four leads (2.9%) had displaced on median follow‐up of 21.8 months (0.5–42 months).Conclusions: The Model 3830 lead is safe and effective in patients with CHD. This is a technically challenging patient group yet procedural complication and lead displacement rates are acceptable.