Epicardial left ventricular leads via minimally invasive technique: a role of steroid eluting leads

Background: We retrospectively assessed two types of sutureless screw-in left ventricular (LV) leads (steroid eluting vs. non-steroid eluting) in cardiac resynchronization therapy (CRT) implantation with regards to their electrical performance. Methods: Between March 2008 and May 2014 an epicardial LV lead was implanted in 32 patients after failed transvenous LV lead placement using a left-sided lateral minithoracotomy or video-assisted thoracoscopy (mean age 64 +/- 9 years). Patients were divided into two groups according to the type of implanted lead. Steroid eluting (SE) group: 21 patients (Myodex (TM) 1084 T; St. Jude Medical) and non-steroid eluting (NSE) group: 11 patients (MyoPore (R) 511,212; Greatbatch Medical). Results: All epicardial leads could be placed successfully, without any intraoperative complications or mortality. With regard to the implanted lead following results were observed: sensing (mV): SE 8.8 +/- 6.1 vs. NSE 10.1 +/- 5.3 (p = 0.380); pacing threshold (V@0.5 ms): SE 1.0 +/- 0.5 vs. NSE 0.9 +/- 0.5 (p = 0.668); impedance (ohms): SE 687 +/- 236 vs. NSE 790 +/- 331 (p = 0.162). At the follow-up (2.6 +/- 1.9 years) the following results were seen: sensing (mV): SE 8.7 +/- 5.0 vs. NSE 11.2 +/- 6.6 (p = 0.241), pacing threshold (V@0.5 ms): SE 1.4 +/- 0.5 vs. NSE 1.0 +/- 0.3 (p = 0.035), impedance (ohms): SE 381 +/- 95 vs. NSE 434 +/- 88 (p = 0.129). Conclusions: Based on the results no strong differences have been found between the both types of epicardial LV leads (steroid eluting vs. non-steroid eluting) in CRT implantation in short-and midterm.