Single-centre experience with coronary sinus lead stability and long-term pacing parameters

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Long-term stability of coronary sinus (CS) pacing leads is crucial for effective cardiac rhythm management.
• Serial X-ray digital imaging has not been extensively used to assess long-term CS lead position.

Purpose of the Study:

• To evaluate the short- and long-term stability of CS lead positions.
• To compare pacing parameters of CS leads over a 12-month period.
• To assess the relationship between lead position changes and pacing parameters.

Main Methods:

• Prospective study involving 93 patients undergoing CS lead implantation.
• Serial X-ray digital imaging (anteroposterior and left lateral views) at implantation, 48 hours, and 12 months.
• Analysis of lead dislodgement, pacing thresholds (LV and RV), and capture thresholds.

Main Results:

• Late CS lead dislodgement (≥12 months) occurred in 8.6% of patients, with one requiring repositioning.
• Minor dislocations (5.4%) were associated with pacing threshold fluctuations.
• Pacing threshold increases were observed in 15% of patients without radiological evidence of lead displacement.
• Left ventricular pacing thresholds were consistently higher than right ventricular thresholds.
• Pacing thresholds were comparable across different lead manufacturers at 12 months.

Conclusions:

• CS lead position can change over a 1-year follow-up, but rarely necessitates reoperation.
• Long-term pacing parameters are comparable among different CS lead manufacturers.
• Increases in pacing threshold are not a reliable indicator of CS lead dislodgement.