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Implantation of CARILLON® Mitral Contour System with transvenous left ventricular lead in place

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Abstract

Background

Cardiac resynchronisation therapy (CRT) is an established treatment option for chronic heart failure patients with left bundle branch block. Although a concomitant functional mitral regurgitation is often reduced by CRT, many patients need additional mitral valve repair. Placing a CARILLON® Mitral Contour System (CMCS) over a transvenous CRT lead is currently not recommended, since both of them are implanted in the coronary sinus (CS). The aim of this study was to investigate the feasibility of sequential implantation of a transvenous LV lead followed by CMCS implantation, and to assess LV lead performance and possibility of extraction.

Methods and results

Standard transvenous LV leads were implanted in the CS of five female sheep. After establishing regular anatomical position with stable electrical parameters of the LV lead, a CMCS was additionally implanted in the CS. After an observation period of 100 days, lead performance and positions of lead and CMCS were studied. Sequential implantation of the two components was feasible in sheep. After 100 days, all leads showed regular measurements of impedance, threshold, and sensing. There was no migration of either the LV lead or the CMCS. In all cases, the LV lead could be completely extracted without migration of the CMCS. There were no acute or long-term complications.

Conclusions

In an animal model of healthy adult sheep, implantation of CMCS with a transvenous LV lead already in place was feasible and without major problems with either the CMCS or the LV lead. Electrical performance of the LV leads was excellent. All LV leads could be extracted without migration of the CMCS.

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Abbreviations

CRT:

Cardiac resynchronisation therapy

CMCS:

CARILLON® Mitral Contour System

CS:

Coronary sinus

LV:

Left ventricular/ventricle

LCX:

Left circumflex coronary artery

FMR:

Functional mitral regurgitation

References

  1. van Bommel RJ, Marsan NA, Delgado V et al (2011) Cardiac resynchronization therapy as a therapeutic option in patients with moderate-severe functional mitral regurgitation and high operative risk. Circulation 124:912–919. doi:10.1161/CIRCULATIONAHA.110.009803

    Article  PubMed  Google Scholar 

  2. Di Biase L, Auricchio A, Mohanty P et al (2011) Impact of cardiac resynchronization therapy on the severity of mitral regurgitation. Europace 13:829–838. doi:10.1093/europace/eur047

    Article  PubMed  Google Scholar 

  3. Auricchio A, Schillinger W, Meyer S et al (2011) Correction of mitral regurgitation in nonresponders to cardiac resynchronization therapy by MitraClip improves symptoms and promotes reverse remodeling. J Am Coll Cardiol 58:2183–2189. doi:10.1016/j.jacc.2011.06.061

    Article  PubMed  Google Scholar 

  4. Siminiak T, Wu JC, Haude M et al (2012) Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial. Eur J Heart Fail 14:931–938. doi:10.1093/eurjhf/hfs076

    Article  PubMed  PubMed Central  Google Scholar 

  5. Schofer J, Siminiak T, Haude M et al (2009) Percutaneous mitral annuloplasty for functional mitral regurgitation: results of the CARILLON Mitral Annuloplasty Device European Union Study. Circulation 120:326–333. doi:10.1161/CIRCULATIONAHA.109.849885

    Article  PubMed  PubMed Central  Google Scholar 

  6. Brignole M, Auricchio A, Barón-Esquivias G et al (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 34:2281–2329. doi:10.1093/eurheartj/eht150

    Article  PubMed  Google Scholar 

  7. Cleland JGF, Freemantle N, Erdmann E et al (2012) Long-term mortality with cardiac resynchronization therapy in the Cardiac Resynchronization-Heart Failure (CARE-HF) trial. Eur J Heart Fail 14:628–634. doi:10.1093/eurjhf/hfs055

    Article  PubMed  Google Scholar 

  8. Trichon BH, Felker GM, Shaw LK et al (2003) Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure. Am J Cardiol 91:538–543

    Article  PubMed  Google Scholar 

  9. Robbins JD, Maniar PB, Cotts W et al (2003) Prevalence and severity of mitral regurgitation in chronic systolic heart failure. Am J Cardiol 91:360–362

    Article  PubMed  Google Scholar 

  10. Sutton MGSJ, Plappert T, Hilpisch KE et al (2006) Sustained reverse left ventricular structural remodeling with cardiac resynchronization at one year is a function of etiology: quantitative Doppler echocardiographic evidence from the Multicenter InSync Randomized Clinical Evaluation (MIRACLE). Circulation 113:266–272. doi:10.1161/CIRCULATIONAHA.104.520817

    Article  PubMed  Google Scholar 

  11. Ypenburg C, Lancellotti P, Tops LF et al (2008) Mechanism of improvement in mitral regurgitation after cardiac resynchronization therapy. Eur Heart J 29:757–765. doi:10.1093/eurheartj/ehn063

    Article  PubMed  Google Scholar 

  12. Porciani MC, Macioce R, Demarchi G et al (2006) Effects of cardiac resynchronization therapy on the mechanisms underlying functional mitral regurgitation in congestive heart failure. Eur J Echocardiogr 7:31–39. doi:10.1016/j.euje.2005.03.008

    Article  PubMed  Google Scholar 

  13. Kienemund J, Kuck K-H, Frerker C (2014) Cardiac resynchronisation therapy or MitraClip® implantation for patients with severe mitral regurgitation and left bundle branch block? Arrhythm Electrophysiol Rev 3:190–193. doi:10.15420/aer.2014.3.3.190

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lipiecki J, Siminiak T, Sievert H et al (2016) Coronary sinus-based percutaneous annuloplasty as treatment for functional mitral regurgitation: the TITAN II trial. Open Heart 3:e000411. doi:10.1136/openhrt-2016-000411

    Article  PubMed  PubMed Central  Google Scholar 

  15. Baddour LM, Epstein AE, Erickson CC et al (2010) Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation 121:458–477. doi:10.1161/CIRCULATIONAHA.109.192665

    Article  PubMed  Google Scholar 

  16. Wilkoff BL, Love CJ, Byrd CL et al. (2009) Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA). Heart Rhythm 6:1085–1104. doi:10.1016/j.hrthm.2009.05.020

    Article  PubMed  Google Scholar 

  17. Siminiak T, Jerzykowska O, Kalmucki P et al (2013) Cardiac resynchronisation therapy after percutaneous trans-coronary-venous mitral annuloplasty. Kardiologia Polska 71:1293–1294. doi:10.5603/KP.2013.0326

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Dr. D. Mahnkopf and Dr. O. Schweitzer for excellent support and reliable cooperation.

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Authors and Affiliations

  1. Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany

    T. Wengenmayer, J. Reinöhl, J. Steinfurt, C. Bode & J. Biermann

  2. IMTR, Institute of Medical Technology and Research, Rottmersleben, Germany

    A. Mittag

Authors
  1. T. Wengenmayer
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  2. J. Reinöhl
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  3. J. Steinfurt
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  4. A. Mittag
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  5. C. Bode
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  6. J. Biermann
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Corresponding author

Correspondence to J. Biermann.

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Conflict of interest

Dr. T. Wengenmayer and Dr. J. Biermann received travel grants from Cardiac Dimensions®. Dr. T. Wengenmayer received fees for speaking from Abbott Vascular®. Dr. J. Reinöhl was supported with a research grant of Cardiac Dimensions®. The other authors state that there is no conflict of interest.

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Supplementary material 1 (DOCX 30 kb)

Video 1: Extraction of LV lead (MOV 825 kb)

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Wengenmayer, T., Reinöhl, J., Steinfurt, J. et al. Implantation of CARILLON® Mitral Contour System with transvenous left ventricular lead in place. Clin Res Cardiol 106, 796–801 (2017). https://doi.org/10.1007/s00392-017-1121-2

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  • DOI: https://doi.org/10.1007/s00392-017-1121-2

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