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Long-term follow-up data of coronary sinus stenting for the stabilization of the left ventricular leads
Ahmet Duran Demir1, Serkan Cay, Ali Riza Erbay
1Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
Insights
Coronary sinus side branch stenting effectively stabilizes dislocated leads for cardiac resynchronization therapy, maintaining lead performance over the long term. This improves therapy effectiveness in heart failure patients.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Cardiac resynchronization therapy (CRT) is vital for heart failure management.
- Dislocated coronary sinus leads compromise CRT efficacy.
- Lead stability is crucial for optimal CRT outcomes.
Purpose of the Study:
- To assess the long-term impact of coronary sinus side branch stenting on left ventricular lead parameters.
- To evaluate the effectiveness of stenting in stabilizing dislocated coronary sinus leads.
Main Methods:
- Eight patients with dislocated coronary sinus leads underwent side branch stenting.
- Lead impedance, capture threshold, and R-wave amplitude were monitored.
- Measurements were taken at implantation and at regular follow-up intervals up to 30.4 months.
Main Results:
- No significant changes in lead impedance, capture threshold, or R-wave amplitude were observed post-stenting.
- Mean lead impedance remained stable (656 ± 162 Ω at implantation vs. 697 ± 164 Ω at follow-up).
- Mean capture threshold (1.1 ± 0.5 V) and R-wave amplitude (13.0 ± 6.8 mV vs. 12.8 ± 6.9 mV) showed no significant long-term differences.
Conclusions:
- Coronary sinus side branch stenting is an effective method for stabilizing dislocated leads.
- Stenting maintains reliable sensing and pacing parameters for CRT.
- This technique offers a viable solution to improve CRT lead stability and effectiveness.
Background:
Cardiac resynchronization therapy has been increasingly used for patients with heart failure. However, unstable and dislocated coronary sinus leads reduce the effectiveness of this important intervention.
Aim:
To examine the long-term effects of coronary sinus side branch stenting on sensing and pacing parameters of the left ventricular leads.
Methods:
A total of eight patients (six males; two females; mean age, 56.6 ± 14.4 years) whose coronary sinus lead dislocated during the procedure were included in the study. Targeted coronary sinus side branch stenting was performed to stabilize the leads. Sensing and pacing parameters including lead impedance, capture threshold, and R-wave amplitude were measured at implantation, first month, sixth month, and every 6-month period.
Results:
Mean follow-up period was 30.4 ± 7.4 months. At the time of implantation, lead impedance, capture threshold, and R-wave amplitude were 656 ± 162 Ω, 1.1 ± 0.5 V, and 13.0 ± 6.8 mV, respectively. No statistically significant mean lead impedance, capture threshold, and R-wave amplitude differences were observed between at the time of implantation and at the time of last follow-up (697 ± 164 Ω, 1.1 ± 0.5 V, 12.8 ± 6.9 mV, respectively).
Conclusion:
In this long-term study, coronary sinus side branch stenting for the stabilization of dislocated leads seems to be effective.
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