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Vijayaraman P, Foo D, Lim TSE, Diamantakos E, Verma S, Hourdain J, Pandurangi U, Bhargava K, Zanon F, Stone J, Lee K, Nair D. Result of the left bundle branch area pacing data collection registry, an international multicenter study of conduction system pacing with a Tendril STS 2088 stylet-driven lead. J Cardiovasc Electrophysiol 2024. [PMID: 38757909 DOI: 10.1111/jce.16274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Left bundle branch area (LBBA) pacing (LBBAP) has been proposed as an alternative therapy option in patients indicated for cardiac pacing to treat bradycardia or heart failure. The aim of the study was to evaluate the safety and effectiveness of LBBAP in patients implanted with a Tendril 2088 stylet-driven lead. METHODS The international retrospective data collection registry included 11 sites from 5 countries globally. Patients with attempted implants of the Tendril lead in the LBBA were followed for at least 6 months post the implant attempt. The primary safety and efficacy endpoints were freedom from LBBAP lead-related serious adverse events and the composite of LBBA capture threshold of ≤2.0 V and R-wave amplitudes ≥5 mV (or ≥value at implant), respectively. RESULTS Of 221 patients with attempted implants of the Tendril 2088 lead in the LBBA, 91.4% (202/221) had successful implants for LBBAP. Regardless of the LBBAP implant success, all patients were followed for at least 6 months (8.7 ± 7.3 months). Baseline characteristics: 44% female, 84% ≥65 years old, 34% coronary artery disease, and 86% of primary indications for pacemaker implant. Both primary safety and effectiveness endpoints were met (freedom from LBBAP lead-related serious adverse device effects of 99.5% and electrical performance composite success rate of 93%). The capture thresholds in LBBAP at implant and 6 months were 0.8 ± 0.3 V@0.4 ± 0.1 ms and 0.8 ± 0.3 V@0.4 ± 0.1 ms. The rate of patients with capture threshold rise ≥1 V was 1.5% through 6 months. The R-wave amplitudes in LBBAP at implant and 6 months were 9.3 ± 3.2 mV and 10.6 ± 3.0 mV. CONCLUSIONS This large multicenter study demonstrates that the stylet-driven Tendril™ STS 2088 lead is safe and effective for LBBAP with high success and low complication rates.
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Affiliation(s)
- Pugazhendhi Vijayaraman
- Geisinger Wyoming Valley Medical Center, Geisinger Heart Institute, Wilkes-Barre, Pennsylvania, USA
| | - David Foo
- Tan Tock Seng Hospital, Singapore, Singapore
| | | | | | - Sumit Verma
- Baptist Heart and Vascular Institute, Pensacola, Florida, USA
| | | | | | | | | | - James Stone
- North Mississippi Medical Center, Tupelo, Mississippi, USA
| | | | - Devi Nair
- Arrhythmia Research Group, Jonesboro, Arkansas, USA
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Li JJ, Liu HH, Wu NQ, Yeo KK, Tan K, Ako J, Krittayaphong R, Tan RS, Aylward PE, Baek SH, Dalal J, Fong AYY, Li YH, O'Brien RC, Lim TSE, Koh SYN, Scherer DJ, Tada H, Kang V, Butters J, Nicholls SJ. Statin intolerance: an updated, narrative review mainly focusing on muscle adverse effects. Expert Opin Drug Metab Toxicol 2020; 16:837-851. [PMID: 32729743 DOI: 10.1080/17425255.2020.1802426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Statins have been established as the standard of care for dyslipidemia and preventing cardiovascular diseases while posing few safety concerns. However, misconceptions about statin intolerance lead to their underuse, indicating a need to improve the understanding of the safety of this treatment. AREAS COVERED We searched PubMed and reviewed literatures related to statin intolerance published between February 2015 and February 2020. Important large-scale or landmark studies published before 2015 were also cited as key evidence. EXPERT OPINION Optimal lowering of low-density lipoprotein cholesterol with statins substantially reduces the risk of cardiovascular events. Muscle adverse events (AEs) were the most frequently reported AEs by statin users in clinical practice, but they usually occurred at a similar rate with statins and placebo in randomized controlled trials and had a spurious causal relationship with statin treatment. We proposed a rigorous definition for identifying true statin intolerance and present the criteria for defining different forms of muscle AEs and an algorithm for their management. True statin intolerance is uncommon, and every effort should be made to exclude false statin intolerance and ensure optimal use of statins. For the management of statin intolerance, statin-based approaches should be prioritized over non-statin approaches.
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Affiliation(s)
- Jian-Jun Li
- State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China
| | - Hui-Hui Liu
- State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China
| | - Na-Qiong Wu
- State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore
| | - Kathryn Tan
- Department of Medicine, University of Hong Kong , Hong Kong, China
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University , Sagamihara, Japan
| | - Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | - Ru San Tan
- Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore
| | - Philip E Aylward
- South Australian Health and Medical Research Institute and Flinders University , Adelaide, Australia
| | - Sang Hong Baek
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Korea
| | - Jamshed Dalal
- Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital , Mumbai, India
| | - Alan Yean Yip Fong
- Department of Cardiology, Sarawak Heart Centre; and Clinical Research Centre, Sarawak General Hospital , Kuching, Malaysia
| | - Yi-Heng Li
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital , Tainan, Taiwan
| | - Richard C O'Brien
- Department of Endocrinology, Austin Health, University of Melbourne , Melbourne, Australia
| | - Tien Siang Eric Lim
- Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore
| | - Si Ya Natalie Koh
- Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore
| | - Daniel J Scherer
- South Australian Health and Medical Research Institute, University of Adelaide , Adelaide, South Australia, Australia
| | - Hayato Tada
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine , Kanazawa, Japan
| | | | - Julie Butters
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University , Melbourne, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University , Melbourne, Australia
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Leong SHB, Chan E, Ho BCH, Yeo C, Lew S, Sewa DW, Lim SL, Lee CW, Chia PL, Lim TSE, Lee EK, Ong MEH. Therapeutic temperature management (TTM): post-resuscitation care for adult cardiac arrest, with recommendations from the National TTM Workgroup. Singapore Med J 2018; 58:408-410. [PMID: 28740998 DOI: 10.11622/smedj.2017067] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Therapeutic temperature management (TTM) was strongly recommended by the 2015 International Liaison Committee on Resuscitation as a component of post-resuscitation care. It has been known to be effective in improving the survival rate and neurologic functional outcome of patients after cardiac arrest. In an effort to increase local adoption of TTM as a standard of post-resuscitation care, this paper discusses and makes recommendations on the treatment for local providers.
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Affiliation(s)
| | - Enoch Chan
- Unit for Prehospital Emergency Care, Singapore General Hospital, Singapore
| | | | - Colin Yeo
- Cardiology Department, Changi General Hospital, Singapore
| | - Sennen Lew
- Medical Intensive Care Unit, Khoo Teck Puat Hospital, Singapore
| | - Duu Wen Sewa
- Medical Intensive Care Unit, Singapore General Hospital, Singapore
| | - Shir Lynn Lim
- Medical Intensive Care Unit, Singapore General Hospital, Singapore
| | - Chee Wan Lee
- Cardiology Department, Khoo Teck Puat Hospital, Singapore
| | - Pow Li Chia
- Cardiology Department, Tan Tock Seng Hospital, Singapore
| | | | - Eng Kiang Lee
- Medical Intensive Care Unit, Ng Teng Fong General Hospital, Singapore
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Lim TSE, Tan BY, Ho KL, Lim CYP, Teo WS, Ching CK. Initial experience of subcutaneous implantable cardioverter defibrillators in Singapore: a case series and review of the literature. Singapore Med J 2015; 56:580-5. [PMID: 26512151 DOI: 10.11622/smedj.2015154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Transvenous implantable cardioverter defibrillators are a type of implantable cardiac device. They are effective at reducing total and arrhythmic mortality in patients at risk of sudden cardiac death. Subcutaneous implantable cardioverter defibrillators (S-ICDs) are a new alternative that avoids the disadvantages of transvenous lead placement. In this case series, we report on the initial feasibility and safety of S-ICD implantation in Singapore.
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Affiliation(s)
| | - Boon Yew Tan
- Department of Cardiology, National Heart Centre, Singapore
| | - Kah Leng Ho
- Department of Cardiology, National Heart Centre, Singapore
| | | | - Wee Siong Teo
- Department of Cardiology, National Heart Centre, Singapore
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