PMID- 31800041
OWN - NLM
STAT- MEDLINE
DCOM- 20201005
LR  - 20201005
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 30
IP  - 3
DP  - 2020 Mar 1
TI  - Outcome of video-assisted thoracoscopic implantation of epicardial left 
      ventricular leads with visual targeting for cardiac resynchronization therapy.
PG  - 373-379
LID - 10.1093/icvts/ivz276 [doi]
AB  - OBJECTIVES: Our goal was to analyse the implantation and outcome of thoracoscopic 
      epicardial leads after a failed endovascular approach or follow-up (FU) 
      complications after endovascular implantation. METHODS: We reviewed the records 
      of patients with failed endovascular left ventricular (LV) lead placement or 
      complications during FU, who were subsequently referred to cardiac surgeons for 
      treatment with thoracoscopic LV lead implantation. We analysed the reasons for 
      endovascular failure; the indications for the surgical procedures; and the 
      clinical, echocardiographic and device FU results. RESULTS: Between 2010 and 
      2013, a total of 23 patients were included. Among them, 17 of the patients had no 
      previous cardiothoracic surgery, 13 (76%) had successful video-assisted 
      thoracoscopy (VAT) LV lead implantation, 3 (18%) had a conversion to thoracotomy 
      and 1 (6%) failed. Of the 6 patients with prior cardiothoracic surgery, 2 (33%) 
      had VAT only, 3 (50%) had primary thoracotomies and 1 (17%) had a conversion. Two 
      major complications occurred. The reasons for LV endovascular lead failure were 
      subclavian vein occlusion (n = 2), implant failure (n = 13) and complications 
      during the FU period (n = 8). FU information was available for 20 patients: 17 
      (85%) had improved symptoms. The median FU period was 33 months. A total of 78% 
      of patients were in New York Heart Association (NYHA) functional class III-IV 
      before the operation; 30% were in NYHA functional class III-IV at the last FU 
      examination. The left ventricular ejection fraction increased from 25% before 
      surgery to 31% at the last FU examination. Overall, sensing and pacing threshold 
      values remained stable over time. In 1 patient, lead revision was necessary due 
      to an increase in the pacing threshold. CONCLUSIONS: VAT implantation of LV leads 
      had an excellent response rate with an improvement in NYHA functional class and 
      left ventricular ejection fraction. The lead measurements were mainly stable over 
      time.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Stauber, Annina
AU  - Stauber A
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Tanner, Hildegard
AU  - Tanner H
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Noti, Fabian
AU  - Noti F
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Roten, Laurent
AU  - Roten L
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Seiler, Jens
AU  - Seiler J
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Lam, Anna
AU  - Lam A
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Medeiros-Domingo, Argelia
AU  - Medeiros-Domingo A
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Servatius, Helge
AU  - Servatius H
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Tran, Van Nam
AU  - Tran VN
AD  - Department of Cardiology, Bern University Hospital, University of Bern, Bern, 
      Switzerland.
FAU - Carrel, Thierry
AU  - Carrel T
AD  - Department of Cardiovascular Surgery, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Weber, Alberto
AU  - Weber A
AD  - Department of Cardiovascular Surgery, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Echocardiography
MH  - *Electrodes, Implanted
MH  - Female
MH  - Heart Failure/diagnosis/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pericardium/*surgery
MH  - Stroke Volume/*physiology
MH  - Thoracic Surgery, Video-Assisted/*methods
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Epicardial lead
OT  - Heart failure
OT  - Left ventricular lead
OT  - Thoracoscopic
OT  - Video-assisted thoracoscopic
EDAT- 2019/12/05 06:00
MHDA- 2020/10/06 06:00
CRDT- 2019/12/05 06:00
PHST- 2019/07/12 00:00 [received]
PHST- 2019/10/05 00:00 [revised]
PHST- 2019/10/23 00:00 [accepted]
PHST- 2019/12/05 06:00 [pubmed]
PHST- 2020/10/06 06:00 [medline]
PHST- 2019/12/05 06:00 [entrez]
AID - 5652056 [pii]
AID - 10.1093/icvts/ivz276 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2020 Mar 1;30(3):373-379. doi: 
      10.1093/icvts/ivz276.