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A survival analysis of bipolar steroid-eluting and unipolar non-steroid-eluting epicardial leads
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  • Amir Farjam Fazelifar,
  • Nina Jalily Taghavyan,
  • mahdi Moeini,
  • Bahador Baharestani,
  • Farshad Jalili Shahandashti,
  • Majid Haghjoo,
  • Saeid Hosseini,
  • Farzad Kamali,
  • Shabnam Madadi,
  • Ali Asghar Yoonesi,
  • Sogol Koolaji
Amir Farjam Fazelifar
Rajaie Cardiovascular Medical and Research Center

Corresponding Author:fazelifar@gmail.com

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Nina Jalily Taghavyan
Rajaie Cardiovascular Medical and Research Center
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mahdi Moeini
Urmia University of Medical Sciences School of Medicine
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Bahador Baharestani
Rajaie Cardiovascular Medical and Research Center
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Farshad Jalili Shahandashti
Rajaie Cardiovascular Medical and Research Center
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Majid Haghjoo
Rajaie Cardiovascular Medical and Research Center
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Saeid Hosseini
Rajaie Cardiovascular Medical and Research Center
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Farzad Kamali
Rajaie Cardiovascular Medical and Research Center
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Shabnam Madadi
Rajaie Cardiovascular Medical and Research Center
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Ali Asghar Yoonesi
Rajaie Cardiovascular Medical and Research Center
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Sogol Koolaji
Rajaie Cardiovascular Medical and Research Center
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Abstract

Background: Epicardial pacemakers are known as an alternative for endocardial pacemakers in some cases such as heart block, and complex congenital heart diseases. Considering recent advances and improvement of epicardial lead subtypes, it is essential to investigate the long-term function of them. In this study, we aimed to assess the sensing and pacing characteristics, and survival of bipolar steroid-eluting and unipolar non-steroid-eluting epicardial pacemakers. Methods: We conducted an entirely concentrated search on the documents of all patients who had undergone epicardial lead implantation in the Shaheed Rajaie Cardiovascular, Medical & Research Center during 2015-2018. Implant, and follow up data were extracted. Kaplan Meier analysis and Weibull regression hazards model were applied for the survival analysis. Results: eighty-nine leads were implanted for 77 patients. Of the total leads, 52.81%, 53.93%, and 47.19% were implanted in children (under-18-year-old), females, and patients with congenital heart diseases, respectively. Bipolar steroid-eluting leads comprised 33.71% of 89 leads. Pacing threshold of unipolar non-steroid-eluting leads that were implanted on the left ventricle and right atrium increased significantly during the follow up to greater records than bipolar steroid-eluting leads. Survival analysis also revealed that bipolar steroid-eluting leads are significantly better in 48-month survival (Weibull HR: 0.13 (95%CI, 0.02-0.99), p-value, 0.049). Age, ventricular location of the lead, and acute pacing characteristics were not associated with survival. Conclusions: Bipolar steroid-eluting epicardial leads have an acceptable survival compared with unipolar non-steroid-eluting, without a significant difference regarding patients age. Therefore, they could be an excellent alternative for endocardial ones.
16 Apr 2022Submitted to Journal of Cardiovascular Electrophysiology
18 Apr 2022Submission Checks Completed
18 Apr 2022Assigned to Editor
19 Apr 2022Reviewer(s) Assigned
16 Jul 2022Review(s) Completed, Editorial Evaluation Pending
18 Jul 2022Editorial Decision: Revise Minor
16 Sep 20221st Revision Received
21 Sep 2022Submission Checks Completed
21 Sep 2022Assigned to Editor
21 Sep 2022Reviewer(s) Assigned
09 Oct 2022Review(s) Completed, Editorial Evaluation Pending
12 Oct 2022Editorial Decision: Accept
31 Oct 2022Published in Journal of Cardiovascular Electrophysiology. 10.1111/jce.15709