Long-Term Follow-Up of Isolated Epicardial Left Ventricular Lead Implant Using a Minithoracotomy Approach for Cardiac...

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Devices

Background:

• Transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy (CRT) has a 5-10% failure rate.
• Patients with failed transvenous leads may benefit from surgical epicardial LV lead placement via minithoracotomy.

Purpose of the Study:

• To evaluate the long-term success and safety of isolated epicardial LV lead implantation after failed transvenous attempts.
• To assess clinical response and recovery in patients undergoing this alternative procedure.

Main Methods:

• Retrospective analysis of consecutive patients undergoing isolated epicardial LV lead placement following failed transvenous attempts over a 6-year period.
• Data collection included baseline parameters, procedural details, hospital stay, complications, mortality, and clinical response at follow-up.

Main Results:

• Forty-two patients underwent epicardial lead implantation. The 1-year mortality rate was 11.9%. Median hospital stay was 3.4 days.
• The overall complication rate was 17.5%, including LV noncapture events, wound infections, and device infections. Of 34 assessed patients, 61.8% were responders to CRT.

Conclusions:

• Isolated epicardial LV lead implantation via minithoracotomy is a relatively safe and effective option for achieving successful LV pacing in patients with prior transvenous lead failure.
• The procedure demonstrates reasonable response rates and postoperative recovery in high-risk patient populations.