Left ventricular endocardial pacing: a transarterial approach.

Area of Science:

• Cardiovascular medicine
• Medical device technology
• Surgical innovation

Background:

• Direct left ventricular endocardial lead placement across the aortic valve is a novel technique.
• Potential risks include aortic valve damage, systemic embolization, and lead performance issues.

Purpose of the Study:

• To assess the feasibility and safety of transaortic left ventricular lead implantation.
• To evaluate lead function and potential complications in a chronic animal model.

Main Methods:

• Ten minipigs underwent transaortic left ventricular lead implantation via the carotid artery.
• Leads were either polyurethane (n=5) or silicone (n=5).
• Pigs received dual antiplatelet therapy for seven days; follow-up was six months with necropsy.

Main Results:

• All surviving pigs (n=7) were healthy at six months.
• Adequate sensing and pacing thresholds were maintained, though pacing thresholds increased.
• Trace to mild aortic insufficiency and no significant thromboembolic events were observed.

Conclusions:

• Direct transaortic left ventricular lead placement is a feasible approach.
• The technique demonstrated safety regarding aortic regurgitation and thromboembolism.
• Polyurethane leads showed better performance with less thrombosis compared to silicone leads.