Premium
Clinical Impact, Safety, and Efficacy of Single‐ versus Dual‐Coil ICD Leads in MADIT‐CRT
Author(s) -
KUTYIFA VALENTINA,
HUTH RUWALD ANNECHRISTINE,
AKTAS MEHMET K.,
JONS CHRISTIAN,
McNITT SCOTT,
POLONSKY BRONISLAVA,
GELLER LASZLO,
MERKELY BELA,
MOSS ARTHUR J.,
ZAREBA WOJCIECH,
BLOCH THOMSEN POUL ERIK
Publication year - 2013
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12219
Subject(s) - medicine , defibrillation threshold , implantable cardioverter defibrillator , cardiology , defibrillation , shock (circulatory) , cardiac resynchronization therapy , lead (geology) , electromagnetic coil , heart failure , ejection fraction , engineering , geomorphology , electrical engineering , geology
Single‐ versus Dual‐Coil ICD Leads Background Current data on efficacy, safety and impact on clinical outcome of single‐ versus dual‐coil implantable cardioverter‐defibrillator (ICD) leads are limited and contradictory. Methods Defibrillation threshold (DFT) at implantation and first shock efficacy were compared in patients implanted with single‐ versus dual‐coil ICD leads in MADIT‐CRT. The risk for atrial tachyarrhythmias and all‐cause mortality were evaluated. Short‐ (< 30 days after the implantation) and long‐term (throughout the entire study duration) complications were assessed. Results Patients with dual‐coil ICD leads had significantly lower DFTs compared to patients with single‐coil ICD leads (17.6 ± 5.8 J vs 19.4 ± 6.1 J, P < 0.001). First shock efficacy was similar among patients with dual and single‐coil ICD leads (89.6% vs 92.3%, P = 1.00). When comparing patients with dual versus single‐coil ICD leads, there was no difference in the risk of atrial tachyarrhythmias (HR = 1.57, 95% CI: 0.81–3.02, P = 0.18), or in the risk of all‐cause mortality (HR = 1.10, 95% CI: 0.58–2.07, P = 0.77). Patients implanted with single‐ or dual‐coil ICD lead had similar short and long‐term complication rates (short‐term HR = 0.96, 95% CI: 0.56–1.65, P = 0.88, long‐term procedure‐related HR = 0.99, 95% CI: 0.62–1.59, P = 1.00, long‐term ICD lead related: HR = 1.2, 95% CI: 0.5–2.9, P = 0.68) during the mean follow‐up of 3.3 years. Conclusions Patients with single‐coil ICD leads have slightly higher DFTs compared to those with dual‐coil leads, but the efficacy, safety, and clinical impact on atrial tachyarrhythmias, and mortality is similar. Implantation of single‐coil ICD leads may be favorable in most patients.