TY - JOUR
T1 - A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes
AU - Turagam, Mohit K.
AU - Afzal, Muhammad R.
AU - Iskander, Sandia
AU - Reddy, Madhu
AU - Di Biase, Luigi
AU - Natale, Andrea
AU - Lakkireddy, Dhanunjaya
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective: We aimed to perform a meta-analysis from eligible studies to analyze the true impact of QL when compared with BL with regard to post-procedural outcomes including lead deactivation, revision or replacement. Background: Many observational and retrospective studies showed that quadripolar left ventricular leads (QL) are associated with better outcomes and fewer complications when compared with bipolar leads (BL). Methods: We performed a comprehensive literature search through June 30, 2015 using: quadripolar, bipolar, left ventricular lead and CRT in Pubmed, Ebsco and google scholar databases. Results: The analysis included 8 studies comparing QL and BL implantation. Post-procedural outcomes such as lead deactivation, revision or replacement were used as primary outcome and assessed with Mantel-Haenszel risk ratio (RR). Secondary outcomes included total fluoroscopy/procedure time, occurrence of phrenic nerve stimulation (PNS) and all-cause mortality on follow up. Follow-up duration for the studies ranged from 3 to 60 months. Compared with BL, the use of QL is associated with 52 % reduction (relative risk 0.48; 95% CI: 0.36-0.64, p=0.00001) in the risk of deactivation, revision or replacement of the LV lead. QL had significantly lower fluoroscopy/procedure time, PNS and all-cause mortality when compared with BL. Conclusion: Our meta-analysis shows that QL implantation was associated with decreased risk of LV lead deactivation, revision or replacement when compared with BL.
AB - Objective: We aimed to perform a meta-analysis from eligible studies to analyze the true impact of QL when compared with BL with regard to post-procedural outcomes including lead deactivation, revision or replacement. Background: Many observational and retrospective studies showed that quadripolar left ventricular leads (QL) are associated with better outcomes and fewer complications when compared with bipolar leads (BL). Methods: We performed a comprehensive literature search through June 30, 2015 using: quadripolar, bipolar, left ventricular lead and CRT in Pubmed, Ebsco and google scholar databases. Results: The analysis included 8 studies comparing QL and BL implantation. Post-procedural outcomes such as lead deactivation, revision or replacement were used as primary outcome and assessed with Mantel-Haenszel risk ratio (RR). Secondary outcomes included total fluoroscopy/procedure time, occurrence of phrenic nerve stimulation (PNS) and all-cause mortality on follow up. Follow-up duration for the studies ranged from 3 to 60 months. Compared with BL, the use of QL is associated with 52 % reduction (relative risk 0.48; 95% CI: 0.36-0.64, p=0.00001) in the risk of deactivation, revision or replacement of the LV lead. QL had significantly lower fluoroscopy/procedure time, PNS and all-cause mortality when compared with BL. Conclusion: Our meta-analysis shows that QL implantation was associated with decreased risk of LV lead deactivation, revision or replacement when compared with BL.
KW - Bipolar lead
KW - Cardiac resynchronization therapy
KW - Congestive heart failure
KW - Meta-analysis
KW - Quadripolar lead
UR - http://www.scopus.com/inward/record.url?scp=84991821251&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84991821251
SN - 1941-6911
VL - 9
SP - 7
EP - 11
JO - Journal of Atrial Fibrillation
JF - Journal of Atrial Fibrillation
IS - 2
ER -