Adverse events with transvenous left ventricular pacing in patients with severe heart failure: early experience from a single centre

• Published in: Europace (London, England) England), 2001-01, Vol.3 (1), p.60-63
• Main Authors: Valls-Bertault, V, Mansourati, J, Gilard, M, Etienne, Y, Munier, S, Blanc, J J
• Format: Article
• Language: English
• Subjects: Aged; Bundle-Branch Block - complications; Bundle-Branch Block - mortality; Bundle-Branch Block - physiopathology; Bundle-Branch Block - therapy; Cardiac Pacing, Artificial - methods; Catheterization, Peripheral - adverse effects; Electrocardiography, Ambulatory; Female; Heart Failure - complications; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Heart Rate; Heart Ventricles; Humans; Male; Pacemaker, Artificial - adverse effects; Prospective Studies; Survival Rate
• ISSN: 1099-5129
• DOI: 10.1053/eupc.2000.0138

Assessment of complications following implantation of transvenous ventricular electrodes to pace the left ventricle. Twenty-eight patients with severe cardiac failure and left bundle branch block were prospectively followed for adverse effects of implantation of a left ventricular transvenous pacing system. Immediate follow-up was associated with loss of left ventricular pacing in nine patients (32%). This was due to lead dislodgement in four cases (corrected by re-operation in three of these cases), and due to increased threshold in five cases (corrected by programming a higher pacing amplitude in all five cases, but with intermittent diaphragmatic contraction in one case). After 1 month, one patient died, one patient with severe coronary heart disease suffered a myocardial infarction, and left ventricular pacing was lost in two patients. Pericardial effusion, new significant ventricular arrhythmias or other adverse effects were not observed. After a mean follow-up of 16 +/- 9.2 months, pacing leads remained stable and no late complications related to the transvenous left ventricular epicardial pacing were observed. Placement of a permanent lead in a tributary of the coronary sinus is feasible without serious adverse effects during the first month. The only frequent adverse event was lead dislodgement; a finding which emphasizes the need for development of specially designed leads for this application.