Georg Semmler1,2, Fabian Barbieri3, Karin Thudt1, Paul Vock1, Deddo Mörtl1, Harald Mayr1, Christian Georg Wollmann1, Agne Adukauskaite3, Bernhard Pfeifer4,5, Thomas Senoner3, Wolfgang Dichtl3. 1. Department of Internal Medicine III, University Clinic St. Pölten & Karl Landsteiner Private University, 3100 St. Pölten, Austria. 2. Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, 1090 Vienna, Austria. 3. Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. 4. Institute of Medical Informatics, UMIT TIROL, Eduard Wallnöfer Zentrum, 6600 Hall in Tirol, Austria. 5. Landesinstitut für Integrierte Versorgung, LIV, Tirol Kliniken GmbH, 6020 Innsbruck, Austria.
Abstract
BACKGROUND: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. METHODS: All patients undergoing implantation of the Osypka QT-5® ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed (n = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan-Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted. RESULTS: Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0-8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8-13.4) and 9.6 mV (IQR 5.6-12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5-0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8-1.3; p < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8-1.2). Impedance significantly declined from 1142 Ω (IQR 955-1285) at implantation to 814 Ω (IQR 701-949; p < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289-652; p < 0.001) at the last check-up. Overall, the Osypka QT-5® ventricular lead was replaced in 36 patients (17.1%). CONCLUSIONS: This report shows an unexpected high rate of technical issues of the Osypka QT-5® ventricular lead during long-term follow-up.
BACKGROUND: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. METHODS: All patients undergoing implantation of the Osypka QT-5® ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed (n = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan-Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted. RESULTS:Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0-8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8-13.4) and 9.6 mV (IQR 5.6-12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5-0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8-1.3; p < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8-1.2). Impedance significantly declined from 1142 Ω (IQR 955-1285) at implantation to 814 Ω (IQR 701-949; p < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289-652; p < 0.001) at the last check-up. Overall, the Osypka QT-5® ventricular lead was replaced in 36 patients (17.1%). CONCLUSIONS: This report shows an unexpected high rate of technical issues of the Osypka QT-5® ventricular lead during long-term follow-up.
Entities:
Keywords:
impedance decline; lead replacement; pacemaker malfunction; reoperation
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