title: An 8-year single-centre experience of cardiac resynchronisation therapy: procedural success, early and late complications, and left ventricular lead performance.
abstract: OBJECTIVE
  Despite the increasing number of device implants worldwide, little is known about the early and late complications of cardiac resynchronisation therapy (CRT) or the incidence of these complications in patients with different heart failure aetiologies. We aim to determine procedural success and early and late complications in CRT patients.
  
  
  RESULTS
  All early (<90 days) and late (>90 days) complications occurring over 490 consecutive CRT procedures in 402 patients, from a large single-centre registry between 2000 and 2009 were analysed. Mean follow-up duration was 1012 ± 610 days. In addition, procedural data and long-term left ventricular (LV) lead performance were examined. The mean age of patients was 65 ± 15 years, 31% were female. The majority of devices (70%) were CRT-defibrillators. Left ventricular lead implantation was achieved after one or more than one attempt in 96.7% of patients (first procedure was successful in 95.1%). The incidence of early and late complications was 9.4% and 6.1% respectively. Infection and lead displacement were the most common complications. Dilated cardiomyopathy (DCM) was associated with significantly more complications than ischaemic cardiomyopathy (P = 0.01) and these occurred later in the DCM population. Long-term LV lead performance was comparable with that of right atrial and ventricular leads.
  
  
  CONCLUSIONS
  Transvenous implantation of the LV lead is safe and achievable for CRT with high procedural success rates. For the first time we describe the late complications from CRT in different heart failure populations. This group of patients must be kept under surveillance, not only for heart failure events but also for device-related issues. The reasons for higher complication rates in DCM patients require further evaluation.
authors: The Heart Hospital, Institute of Cardiovascular Sciences, 16-18 Westmoreland Street, London, London, UK. syedyahsan@hotmail.com
authors: Syed Y
authors: SY
authors: Ahsan
authors: Bunny
authors: B
authors: Saberwal
authors: Pier D
authors: PD
authors: Lambiase
authors: Sanjay
authors: S
authors: Chaubey
authors: Oliver R
authors: OR
authors: Segal
authors: Aerokondal B
authors: AB
authors: Gopalamurugan
authors: James
authors: J
authors: McCready
authors: Dominic P
authors: DP
authors: Rogers
authors: Martin D
authors: MD
authors: Lowe
authors: Anthony W C
authors: AW
authors: Chow
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000401:mortality*; D058409:Cardiac Resynchronization Therapy Devices / Q000706:statistics & numerical data; D009202:Cardiomyopathies / Q000453:epidemiology*; D015897:Comorbidity; D004567:Electrodes, Implanted / Q000706:statistics & numerical data*; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology*; D006333:Heart Failure / Q000453:epidemiology* / Q000517:prevention & control*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology