Objective: We aimed to perform a meta-analysis from eligible studies to analyze the true impact of QL when compared with BL with regard to post-procedural outcomes including lead deactivation, revision or replacement.
Background: Many observational and retrospective studies showed that quadripolar left ventricular leads (QL) are associated with better outcomes and fewer complications when compared with bipolar leads (BL).
Methods: We performed a comprehensive literature search through June 30, 2015 using: quadripolar, bipolar, left ventricular lead and CRT in Pubmed, Ebsco and google scholar databases.
Results: The analysis included 8 studies comparing QL and BL implantation. Post-procedural outcomes such as lead deactivation, revision or replacement were used as primary outcome and assessed with Mantel–Haenszel risk ratio (RR). Secondary outcomes included total fluoroscopy/procedure time, occurrence of phrenic nerve stimulation (PNS) and all-cause mortality on follow up. Follow-up duration for the studies ranged from 3 to 60 months. Compared with BL, the use of QL is associated with 52 % reduction (relative risk 0.48; 95% CI: 0.36-0.64, p=0.00001) in the risk of deactivation, revision or replacement of the LV lead. QL had significantly lower fluoroscopy/procedure time, PNS and all-cause mortality when compared with BL.
Conclusion: Our meta-analysis shows that QL implantation was associated with decreased risk of LV lead deactivation, revision or replacement when compared with BL.
Credits: Mohit K. Turagam; Muhammad R. Afzal; Sandia Iskander; Madhu Reddy; Luigi Di Biase; Andrea Natale; Dhanunjaya Lakkireddy