Comparing Conduction System Pacing and Surgical Left Ventricular Epicardial Lead Placement for Patients with Coronary Sinus Lead Failure in Heart Failure with Reduced Ejection Fraction

What this Trial Is About

This research aims to compare two approaches for patients with heart failure with reduced ejection fraction HFrEF who have experienced coronary sinus CS lead failure after receiving cardiac resynchronization therapy with defibrillator CRT-D. The study evaluates epicardial lead placement through surgery versus conduction system pacing CSP to see which method may be more effective after lead failure. The trial addresses the lack of clear guidelines and direct comparisons between these two alternatives in patients who have not responded fully to conventional biventricular pacing CRT. Participants include those who had CS lead failure and underwent either transthoracic left ventricular epicardial lead placement or conduction system pacing as lead revision strategies. The study is observational and retrospective, focusing on patients who had lead placement with devices from Medtronic, Boston Scientific, or Abbott. The two groups being compared are those receiving CSP and those receiving epicardial lead placement, with data collected from past procedures. During the study, researchers review patient records to assess outcomes like the need for further lead revision on the day of the procedure and electrocardiography characteristics, specifically the QRS interval. This observational approach collects data without administering new treatments. The study began in November 2023 and aims to complete data collection by December 2024. Participants are adults aged 18 and older who have experienced lead failure after CRT-D implantation.

Conduction System Vs Surgical Left Ventricular Epicardial Pacing For Coronary Sinus Lead Failure