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Clinical Impact, Safety, and Efficacy of Single- versus Dual-Coil ICD Leads in MADIT-CRT.
- Source :
-
Journal of Cardiovascular Electrophysiology . Nov2013, Vol. 24 Issue 11, p1246-1252. 7p. 5 Charts, 2 Graphs. - Publication Year :
- 2013
-
Abstract
- Single- versus Dual-Coil ICD Leads Background Current data on efficacy, safety and impact on clinical outcome of single- versus dual-coil implantable cardioverter-defibrillator (ICD) leads are limited and contradictory. Methods Defibrillation threshold (DFT) at implantation and first shock efficacy were compared in patients implanted with single- versus dual-coil ICD leads in MADIT-CRT. The risk for atrial tachyarrhythmias and all-cause mortality were evaluated. Short- (< 30 days after the implantation) and long-term (throughout the entire study duration) complications were assessed. Results Patients with dual-coil ICD leads had significantly lower DFTs compared to patients with single-coil ICD leads (17.6 ± 5.8 J vs 19.4 ± 6.1 J, P < 0.001). First shock efficacy was similar among patients with dual and single-coil ICD leads (89.6% vs 92.3%, P = 1.00). When comparing patients with dual versus single-coil ICD leads, there was no difference in the risk of atrial tachyarrhythmias (HR = 1.57, 95% CI: 0.81-3.02, P = 0.18), or in the risk of all-cause mortality (HR = 1.10, 95% CI: 0.58-2.07, P = 0.77). Patients implanted with single- or dual-coil ICD lead had similar short and long-term complication rates (short-term HR = 0.96, 95% CI: 0.56-1.65, P = 0.88, long-term procedure-related HR = 0.99, 95% CI: 0.62-1.59, P = 1.00, long-term ICD lead related: HR = 1.2, 95% CI: 0.5-2.9, P = 0.68) during the mean follow-up of 3.3 years. Conclusions Patients with single-coil ICD leads have slightly higher DFTs compared to those with dual-coil leads, but the efficacy, safety, and clinical impact on atrial tachyarrhythmias, and mortality is similar. Implantation of single-coil ICD leads may be favorable in most patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TACHYCARDIA
*IMPLANTABLE cardioverter-defibrillators
*CLINICAL trials
*CONFIDENCE intervals
*ELECTRODES
*FISHER exact test
*HEART atrium
*ARTIFICIAL implants
*LONGITUDINAL method
*EVALUATION of medical care
*PATIENT safety
*STATISTICS
*SURVIVAL analysis (Biometry)
*PROPORTIONAL hazards models
*DATA analysis software
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*STANDARDS
*EQUIPMENT & supplies
*DISEASE risk factors
MORTALITY risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 10453873
- Volume :
- 24
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiovascular Electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 91674026
- Full Text :
- https://doi.org/10.1111/jce.12219