Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective
Objective: Finding an optimum epicardial pacing site in children needing lead replacement can be challenging. We report the midterm outcome of using transvenous SelectSecure leads in the epicardial position. Methods: Between 2018 and 2020, 6 patients (5 children and 1 adult) received 8 SelectSecure...
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Elsevier
2025-08-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250725002329 |
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| author | Seraina Brütsch, MD Christian Balmer, MD Hitendu Dave, MD |
| author_facet | Seraina Brütsch, MD Christian Balmer, MD Hitendu Dave, MD |
| author_sort | Seraina Brütsch, MD |
| collection | DOAJ |
| description | Objective: Finding an optimum epicardial pacing site in children needing lead replacement can be challenging. We report the midterm outcome of using transvenous SelectSecure leads in the epicardial position. Methods: Between 2018 and 2020, 6 patients (5 children and 1 adult) received 8 SelectSecure 3830 leads (“off-label”) in the epicardial position: both the left atrium and left ventricle in 2 patients, only the left ventricle in 3 patients, and the right ventricle in 1 patient. The median age at lead implantation was 14 (4-35) years. Periodic pacing threshold, sensing, and impedance measurements were analyzed. Results: Lead implantations could be performed in all patients without complications, despite scarring from previous surgeries. The median pacing, sensing, and impedance measurements for 6 ventricular leads were 0.75 V, 6.5 mV, and 576 Ohm, respectively. The same for 2 atrial leads were 1.25 V, 2.5 mV, and 758 Ohm, respectively. During a follow-up period of 23.4 (8-32) months, despite a small increase at 6 months, pacing and sensing parameters remained acceptable. One reoperation occurred after the follow-up period due to lead dysfunction. One young patient with a complex structural heart disease and terminal heart failure on a ventricular assist device died while waiting for a heart transplant. Conclusions: The implantation of transvenous leads in the epicardial position is feasible and provides an alternative for cardiac pacing in patients with multiple previous surgeries and epicardial scarring. This lead design, although appealing, poses challenges for stable epicardial fixation. A larger experience and longer follow-up would decide its exact role in epicardial pacing. |
| format | Article |
| id | doaj-art-6f20fd3de57e4eb9be8a1815ce1e0d8e |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-6f20fd3de57e4eb9be8a1815ce1e0d8e2025-08-20T03:36:44ZengElsevierJTCVS Techniques2666-25072025-08-013214415110.1016/j.xjtc.2025.05.011Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspectiveSeraina Brütsch, MD0Christian Balmer, MD1Hitendu Dave, MD2Division of Congenital Cardiovascular Surgery, Pediatric Heart Centre & Children's Research Centre, University Children's Hospital Zürich, Zürich, SwitzerlandDivision of Cardiology, Pediatric Heart Centre & Children's Research Centre, University Children's Hospital Zürich, Zürich, SwitzerlandDivision of Congenital Cardiovascular Surgery, Pediatric Heart Centre & Children's Research Centre, University Children's Hospital Zürich, Zürich, Switzerland; Address for reprints: Hitendu Dave, MD, Division of Congenital Cardiovascular Surgery, Pediatric Heart Centre & Children's Research Centre, University Children's Hospital, Lenggstrasse 30, 8008 Zürich, Switzerland.Objective: Finding an optimum epicardial pacing site in children needing lead replacement can be challenging. We report the midterm outcome of using transvenous SelectSecure leads in the epicardial position. Methods: Between 2018 and 2020, 6 patients (5 children and 1 adult) received 8 SelectSecure 3830 leads (“off-label”) in the epicardial position: both the left atrium and left ventricle in 2 patients, only the left ventricle in 3 patients, and the right ventricle in 1 patient. The median age at lead implantation was 14 (4-35) years. Periodic pacing threshold, sensing, and impedance measurements were analyzed. Results: Lead implantations could be performed in all patients without complications, despite scarring from previous surgeries. The median pacing, sensing, and impedance measurements for 6 ventricular leads were 0.75 V, 6.5 mV, and 576 Ohm, respectively. The same for 2 atrial leads were 1.25 V, 2.5 mV, and 758 Ohm, respectively. During a follow-up period of 23.4 (8-32) months, despite a small increase at 6 months, pacing and sensing parameters remained acceptable. One reoperation occurred after the follow-up period due to lead dysfunction. One young patient with a complex structural heart disease and terminal heart failure on a ventricular assist device died while waiting for a heart transplant. Conclusions: The implantation of transvenous leads in the epicardial position is feasible and provides an alternative for cardiac pacing in patients with multiple previous surgeries and epicardial scarring. This lead design, although appealing, poses challenges for stable epicardial fixation. A larger experience and longer follow-up would decide its exact role in epicardial pacing.http://www.sciencedirect.com/science/article/pii/S2666250725002329congenital heart diseaseepicardial pacingpediatricpermanent pacemakertransvenous 3830 selectsecure pacing lead |
| spellingShingle | Seraina Brütsch, MD Christian Balmer, MD Hitendu Dave, MD Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective JTCVS Techniques congenital heart disease epicardial pacing pediatric permanent pacemaker transvenous 3830 selectsecure pacing lead |
| title | Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective |
| title_full | Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective |
| title_fullStr | Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective |
| title_full_unstemmed | Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective |
| title_short | Transvenous pacing leads implanted in epicardial position: A recipe for future epicardial pacing electrode?Central MessagePerspective |
| title_sort | transvenous pacing leads implanted in epicardial position a recipe for future epicardial pacing electrode central messageperspective |
| topic | congenital heart disease epicardial pacing pediatric permanent pacemaker transvenous 3830 selectsecure pacing lead |
| url | http://www.sciencedirect.com/science/article/pii/S2666250725002329 |
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