Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease

Abstract Background Conduction system pacing prevents pacing‐induced cardiomyopathy, but it can be challenging to perform in patients with congenital heart disease (CHD), and mid/high septal lead implantation is an alternative. This study aimed to assess intraprocedural angiography's utility as...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jayaprakash Shenthar, Sanjai P. Valappil, Maneesh K. Rai, Bharatraj Banavalikar, Deepak Padmanabhan, Tammo Delhaas
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	angiography congenital heart disease imaging permanent pacemaker implantation septal pacing Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f8d1a797f8964e7bb4f2e67a3033aac7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f8d1a797f8964e7bb4f2e67a3033aac7
record_format	dspace
spelling	oai:doaj.org-article:f8d1a797f8964e7bb4f2e67a3033aac72021-12-02T08:25:11ZAngiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease1883-21481880-427610.1002/joa3.12636https://doaj.org/article/f8d1a797f8964e7bb4f2e67a3033aac72021-12-01T00:00:00Zhttps://doi.org/10.1002/joa3.12636https://doaj.org/toc/1880-4276https://doaj.org/toc/1883-2148Abstract Background Conduction system pacing prevents pacing‐induced cardiomyopathy, but it can be challenging to perform in patients with congenital heart disease (CHD), and mid/high septal lead implantation is an alternative. This study aimed to assess intraprocedural angiography's utility as a guide for mid/high‐septal lead implantation in CHD patients. Methods The study subjects were CHD patients with Class I/IIa indications for permanent pacemaker implantation. To guide septal lead implantation, we performed an intraprocedural right ventricular angiogram in anteroposterior, 40° left anterior oblique, and 30° right anterior oblique. The primary endpoint was the lead tip in the mid/high septum on computed tomography (CT). The secondary endpoints were complications and systemic ventricular function on follow‐up. Results From January 2008 to December 2018, we enrolled 27 patients (mean age: 30 ± 20 years; M:F 17:10) with CHD (unoperated: 20, operated: 7). The mean paced QRS duration was 131.7 ± 5.8 ms, and CT done in 22/27 patients confirmed the lead tip in the mid‐septum in 16, high septum in 5, and apical septum in 1 patient. There were no procedural complications, and during a mean follow‐up of 58 ± 35.2 months, there was no significant change in the systemic ventricular ejection fraction (56.4 ± 8.3% vs 53.9 + 5.9%, P = .08). Two patients with Eisenmenger syndrome died because of refractory heart failure. Conclusions Intraprocedural angiography is safe and useful to guide mid/high‐septal lead implantation in CHD patients. Mid/high septal lead position preserves systemic ventricular function in patients with CHD during medium‐term follow‐up.Jayaprakash ShentharSanjai P. ValappilManeesh K. RaiBharatraj BanavalikarDeepak PadmanabhanTammo DelhaasWileyarticleangiographycongenital heart diseaseimagingpermanent pacemaker implantationseptal pacingDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Arrhythmia, Vol 37, Iss 6, Pp 1512-1521 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	angiography congenital heart disease imaging permanent pacemaker implantation septal pacing Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	angiography congenital heart disease imaging permanent pacemaker implantation septal pacing Diseases of the circulatory (Cardiovascular) system RC666-701 Jayaprakash Shenthar Sanjai P. Valappil Maneesh K. Rai Bharatraj Banavalikar Deepak Padmanabhan Tammo Delhaas Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
description	Abstract Background Conduction system pacing prevents pacing‐induced cardiomyopathy, but it can be challenging to perform in patients with congenital heart disease (CHD), and mid/high septal lead implantation is an alternative. This study aimed to assess intraprocedural angiography's utility as a guide for mid/high‐septal lead implantation in CHD patients. Methods The study subjects were CHD patients with Class I/IIa indications for permanent pacemaker implantation. To guide septal lead implantation, we performed an intraprocedural right ventricular angiogram in anteroposterior, 40° left anterior oblique, and 30° right anterior oblique. The primary endpoint was the lead tip in the mid/high septum on computed tomography (CT). The secondary endpoints were complications and systemic ventricular function on follow‐up. Results From January 2008 to December 2018, we enrolled 27 patients (mean age: 30 ± 20 years; M:F 17:10) with CHD (unoperated: 20, operated: 7). The mean paced QRS duration was 131.7 ± 5.8 ms, and CT done in 22/27 patients confirmed the lead tip in the mid‐septum in 16, high septum in 5, and apical septum in 1 patient. There were no procedural complications, and during a mean follow‐up of 58 ± 35.2 months, there was no significant change in the systemic ventricular ejection fraction (56.4 ± 8.3% vs 53.9 + 5.9%, P = .08). Two patients with Eisenmenger syndrome died because of refractory heart failure. Conclusions Intraprocedural angiography is safe and useful to guide mid/high‐septal lead implantation in CHD patients. Mid/high septal lead position preserves systemic ventricular function in patients with CHD during medium‐term follow‐up.
format	article
author	Jayaprakash Shenthar Sanjai P. Valappil Maneesh K. Rai Bharatraj Banavalikar Deepak Padmanabhan Tammo Delhaas
author_facet	Jayaprakash Shenthar Sanjai P. Valappil Maneesh K. Rai Bharatraj Banavalikar Deepak Padmanabhan Tammo Delhaas
author_sort	Jayaprakash Shenthar
title	Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
title_short	Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
title_full	Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
title_fullStr	Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
title_full_unstemmed	Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
title_sort	angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/f8d1a797f8964e7bb4f2e67a3033aac7
work_keys_str_mv	AT jayaprakashshenthar angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease AT sanjaipvalappil angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease AT maneeshkrai angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease AT bharatrajbanavalikar angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease AT deepakpadmanabhan angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease AT tammodelhaas angiographyguidedmidhighseptalimplantationofventricularleadsinpatientswithcongenitalheartdisease
_version_	1718398520202887168

Angiography‐guided mid/high septal implantation of ventricular leads in patients with congenital heart disease

Ejemplares similares