Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy
Purpose Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternati...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2017-03, Vol.48 (2), p.113-120 |
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| container_title | Journal of interventional cardiac electrophysiology |
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| creator | Kis, Zsuzsanna Arany, Andrea Gyori, Gabriella Mihalcz, Attila Kardos, Attila Foldesi, Csaba Kassai, Imre Szili-Torok, Tamas |
| description | Purpose
Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique. The aim of the present prospective study is to determine the long-term outcome, including the cerebral thromboembolic complications, of pts who underwent TALV lead placement.
Methods
Twenty-six CRT candidates (19 men (78 %); mean age 61 ± 10 years) with a previously failed transvenous approach underwent TALV lead placement as a last resort therapy. The following data was collected: mortality rate, reoperation rate, and cerebrovascular event rate. Patients underwent a cerebral CT scan to determine any possible cerebrovascular event related to the presence of the TALV lead.
Results
Eleven out of 26 (47 %) patients survived after a median follow-up of 40 ± 24.5 months. Major acute ischemic stroke occurred in two cases, while in one case transient ischemic stroke was observed. Cerebral CT scan examination performed in asymptomatic patients revealed chronic ischemic lesions with minimal extension in two patients. Reoperation occurred in one case due to TALV lead fracture.
Conclusions
This is the first study reporting the long-term outcome, mortality, and thromboembolic event rate exclusively after TALV lead implantation. Patients who underwent TALV lead implantation have a comparable long-term mortality rate to conventional CRT, although a major ischemic cerebrovascular event after TALV lead implantation is worrisome and has an impact on the outcome. |
| doi_str_mv | 10.1007/s10840-016-0206-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5325848</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4317053991</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-6ae0aae7b523583ea6975f1b571bbda448fb845a9c8762a1c306ec8ea2a7f2db3</originalsourceid><addsrcrecordid>eNqNkU2LFDEQhoMo7rr6A7xIg5e9xM1H56MvgiyuCgN7UfAWKunq2V66kzbpEcZfb8ZZl1UQPIQqUk-9VclLyEvO3nDGzEXhzLaMMq4pE0xT_YiccmUEtapTj2suraTWqK8n5Fkpt4yxjgn9lJwIY6W1hp-SfpPilq6Y5yZgRp9hatabnGafsJ5pDE1I81IjrGOKpUlDs2aIBZZ6NTUY-xQg92PNM5Z9DLU5jj9-0VUJMyz75-TJAFPBF3fxjHy5ev_58iPdXH_4dPluQ4NicqUakAGg8UpIZSWC7owauFeGe99D29rB21ZBF6zRAniQTGOwCALMIHovz8jbo-6y8zP2AWNddXJLHmfIe5dgdH9W4njjtum7U1Io29oqcH4nkNO3HZbVzWMJOE0QMe2K49YY23adav8DlR3nrLUH1dd_obdpl2P9iYMgN1oKpirFj1TIqZSMw_3enLmD3e5ot6t2u4PdTteeVw8ffN_x298KiCNQailuMT8Y_U_Vn4lSuNM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1871763205</pqid></control><display><type>article</type><title>Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kis, Zsuzsanna ; Arany, Andrea ; Gyori, Gabriella ; Mihalcz, Attila ; Kardos, Attila ; Foldesi, Csaba ; Kassai, Imre ; Szili-Torok, Tamas</creator><creatorcontrib>Kis, Zsuzsanna ; Arany, Andrea ; Gyori, Gabriella ; Mihalcz, Attila ; Kardos, Attila ; Foldesi, Csaba ; Kassai, Imre ; Szili-Torok, Tamas</creatorcontrib><description>Purpose
Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique. The aim of the present prospective study is to determine the long-term outcome, including the cerebral thromboembolic complications, of pts who underwent TALV lead placement.
Methods
Twenty-six CRT candidates (19 men (78 %); mean age 61 ± 10 years) with a previously failed transvenous approach underwent TALV lead placement as a last resort therapy. The following data was collected: mortality rate, reoperation rate, and cerebrovascular event rate. Patients underwent a cerebral CT scan to determine any possible cerebrovascular event related to the presence of the TALV lead.
Results
Eleven out of 26 (47 %) patients survived after a median follow-up of 40 ± 24.5 months. Major acute ischemic stroke occurred in two cases, while in one case transient ischemic stroke was observed. Cerebral CT scan examination performed in asymptomatic patients revealed chronic ischemic lesions with minimal extension in two patients. Reoperation occurred in one case due to TALV lead fracture.
Conclusions
This is the first study reporting the long-term outcome, mortality, and thromboembolic event rate exclusively after TALV lead implantation. Patients who underwent TALV lead implantation have a comparable long-term mortality rate to conventional CRT, although a major ischemic cerebrovascular event after TALV lead implantation is worrisome and has an impact on the outcome.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-016-0206-6</identifier><identifier>PMID: 27838871</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Cardiac Resynchronization Therapy - methods ; Cardiac Resynchronization Therapy - mortality ; Cardiac Resynchronization Therapy - utilization ; Cardiology ; Causality ; Comorbidity ; Female ; Heart Failure - mortality ; Heart Failure - prevention & control ; Humans ; Hungary - epidemiology ; Incidence ; Intracranial Embolism - diagnosis ; Intracranial Embolism - mortality ; Intracranial Thrombosis - diagnosis ; Intracranial Thrombosis - mortality ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Reoperation - mortality ; Risk Factors ; Survival Rate ; Treatment Outcome</subject><ispartof>Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.113-120</ispartof><rights>The Author(s) 2016</rights><rights>Journal of Interventional Cardiac Electrophysiology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-6ae0aae7b523583ea6975f1b571bbda448fb845a9c8762a1c306ec8ea2a7f2db3</citedby><cites>FETCH-LOGICAL-c503t-6ae0aae7b523583ea6975f1b571bbda448fb845a9c8762a1c306ec8ea2a7f2db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-016-0206-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-016-0206-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27838871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kis, Zsuzsanna</creatorcontrib><creatorcontrib>Arany, Andrea</creatorcontrib><creatorcontrib>Gyori, Gabriella</creatorcontrib><creatorcontrib>Mihalcz, Attila</creatorcontrib><creatorcontrib>Kardos, Attila</creatorcontrib><creatorcontrib>Foldesi, Csaba</creatorcontrib><creatorcontrib>Kassai, Imre</creatorcontrib><creatorcontrib>Szili-Torok, Tamas</creatorcontrib><title>Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique. The aim of the present prospective study is to determine the long-term outcome, including the cerebral thromboembolic complications, of pts who underwent TALV lead placement.
Methods
Twenty-six CRT candidates (19 men (78 %); mean age 61 ± 10 years) with a previously failed transvenous approach underwent TALV lead placement as a last resort therapy. The following data was collected: mortality rate, reoperation rate, and cerebrovascular event rate. Patients underwent a cerebral CT scan to determine any possible cerebrovascular event related to the presence of the TALV lead.
Results
Eleven out of 26 (47 %) patients survived after a median follow-up of 40 ± 24.5 months. Major acute ischemic stroke occurred in two cases, while in one case transient ischemic stroke was observed. Cerebral CT scan examination performed in asymptomatic patients revealed chronic ischemic lesions with minimal extension in two patients. Reoperation occurred in one case due to TALV lead fracture.
Conclusions
This is the first study reporting the long-term outcome, mortality, and thromboembolic event rate exclusively after TALV lead implantation. Patients who underwent TALV lead implantation have a comparable long-term mortality rate to conventional CRT, although a major ischemic cerebrovascular event after TALV lead implantation is worrisome and has an impact on the outcome.</description><subject>Cardiac Resynchronization Therapy - methods</subject><subject>Cardiac Resynchronization Therapy - mortality</subject><subject>Cardiac Resynchronization Therapy - utilization</subject><subject>Cardiology</subject><subject>Causality</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - prevention & control</subject><subject>Humans</subject><subject>Hungary - epidemiology</subject><subject>Incidence</subject><subject>Intracranial Embolism - diagnosis</subject><subject>Intracranial Embolism - mortality</subject><subject>Intracranial Thrombosis - diagnosis</subject><subject>Intracranial Thrombosis - mortality</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Reoperation - mortality</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU2LFDEQhoMo7rr6A7xIg5e9xM1H56MvgiyuCgN7UfAWKunq2V66kzbpEcZfb8ZZl1UQPIQqUk-9VclLyEvO3nDGzEXhzLaMMq4pE0xT_YiccmUEtapTj2suraTWqK8n5Fkpt4yxjgn9lJwIY6W1hp-SfpPilq6Y5yZgRp9hatabnGafsJ5pDE1I81IjrGOKpUlDs2aIBZZ6NTUY-xQg92PNM5Z9DLU5jj9-0VUJMyz75-TJAFPBF3fxjHy5ev_58iPdXH_4dPluQ4NicqUakAGg8UpIZSWC7owauFeGe99D29rB21ZBF6zRAniQTGOwCALMIHovz8jbo-6y8zP2AWNddXJLHmfIe5dgdH9W4njjtum7U1Io29oqcH4nkNO3HZbVzWMJOE0QMe2K49YY23adav8DlR3nrLUH1dd_obdpl2P9iYMgN1oKpirFj1TIqZSMw_3enLmD3e5ot6t2u4PdTteeVw8ffN_x298KiCNQailuMT8Y_U_Vn4lSuNM</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Kis, Zsuzsanna</creator><creator>Arany, Andrea</creator><creator>Gyori, Gabriella</creator><creator>Mihalcz, Attila</creator><creator>Kardos, Attila</creator><creator>Foldesi, Csaba</creator><creator>Kassai, Imre</creator><creator>Szili-Torok, Tamas</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170301</creationdate><title>Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy</title><author>Kis, Zsuzsanna ; Arany, Andrea ; Gyori, Gabriella ; Mihalcz, Attila ; Kardos, Attila ; Foldesi, Csaba ; Kassai, Imre ; Szili-Torok, Tamas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-6ae0aae7b523583ea6975f1b571bbda448fb845a9c8762a1c306ec8ea2a7f2db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cardiac Resynchronization Therapy - methods</topic><topic>Cardiac Resynchronization Therapy - mortality</topic><topic>Cardiac Resynchronization Therapy - utilization</topic><topic>Cardiology</topic><topic>Causality</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - prevention & control</topic><topic>Humans</topic><topic>Hungary - epidemiology</topic><topic>Incidence</topic><topic>Intracranial Embolism - diagnosis</topic><topic>Intracranial Embolism - mortality</topic><topic>Intracranial Thrombosis - diagnosis</topic><topic>Intracranial Thrombosis - mortality</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Reoperation - mortality</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kis, Zsuzsanna</creatorcontrib><creatorcontrib>Arany, Andrea</creatorcontrib><creatorcontrib>Gyori, Gabriella</creatorcontrib><creatorcontrib>Mihalcz, Attila</creatorcontrib><creatorcontrib>Kardos, Attila</creatorcontrib><creatorcontrib>Foldesi, Csaba</creatorcontrib><creatorcontrib>Kassai, Imre</creatorcontrib><creatorcontrib>Szili-Torok, Tamas</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kis, Zsuzsanna</au><au>Arany, Andrea</au><au>Gyori, Gabriella</au><au>Mihalcz, Attila</au><au>Kardos, Attila</au><au>Foldesi, Csaba</au><au>Kassai, Imre</au><au>Szili-Torok, Tamas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>48</volume><issue>2</issue><spage>113</spage><epage>120</epage><pages>113-120</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique. The aim of the present prospective study is to determine the long-term outcome, including the cerebral thromboembolic complications, of pts who underwent TALV lead placement.
Methods
Twenty-six CRT candidates (19 men (78 %); mean age 61 ± 10 years) with a previously failed transvenous approach underwent TALV lead placement as a last resort therapy. The following data was collected: mortality rate, reoperation rate, and cerebrovascular event rate. Patients underwent a cerebral CT scan to determine any possible cerebrovascular event related to the presence of the TALV lead.
Results
Eleven out of 26 (47 %) patients survived after a median follow-up of 40 ± 24.5 months. Major acute ischemic stroke occurred in two cases, while in one case transient ischemic stroke was observed. Cerebral CT scan examination performed in asymptomatic patients revealed chronic ischemic lesions with minimal extension in two patients. Reoperation occurred in one case due to TALV lead fracture.
Conclusions
This is the first study reporting the long-term outcome, mortality, and thromboembolic event rate exclusively after TALV lead implantation. Patients who underwent TALV lead implantation have a comparable long-term mortality rate to conventional CRT, although a major ischemic cerebrovascular event after TALV lead implantation is worrisome and has an impact on the outcome.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27838871</pmid><doi>10.1007/s10840-016-0206-6</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.113-120 |
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| subjects | Cardiac Resynchronization Therapy - methods Cardiac Resynchronization Therapy - mortality Cardiac Resynchronization Therapy - utilization Cardiology Causality Comorbidity Female Heart Failure - mortality Heart Failure - prevention & control Humans Hungary - epidemiology Incidence Intracranial Embolism - diagnosis Intracranial Embolism - mortality Intracranial Thrombosis - diagnosis Intracranial Thrombosis - mortality Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Reoperation - mortality Risk Factors Survival Rate Treatment Outcome |
| title | Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy |
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