Comparison of single-coil lead versus dual-coil lead of implantable cardioverter defibrillator on lead-related venous complications in a canine model
Dual- coil lead (DCL) of implantable cardioverter defibrillator (ICD) is preferred clinically in patients. However, it is related to higher risk of venous stenosis and thrombosis. The present study was done to compare the fibrosis and extraction of the leads between the single-coil lead (SCL) and DCL in animal models.
This was a chronic animal study with a follow-up duration of 6 months. Twenty mongrel dogs were randomly divided into DCL group or SCL group. Venography was performed before the sacrifice to evaluate the venous stenosis in vivo. The maximum pulling-out tension of the ICD lead was measured by a tensometer. Hematoxylin-eosin stain and toluidine blue O stain were applied to show the pathological changes of the superior vena cava (SVC) to evaluate the fibrosis and the thickness of the SVC adjacent to the leads.
The DCL group showed higher incidence of venous stenosis (OR = 31.5; 95% CI, 2.35–422.3; p = 0.005). It revealed increased tension to extract the leads in the DCL group (5.96 ± 1.86 vs. 3.68 ± 1.46 N, p = 0.027). The difference of venous wall thickness of SVC was 4.3 ± 0.3 fold-changes between two groups (p = 0.007). Moreover, the degree of venous wall fibrosis in DCL group was more serious than that it in SCL group (3.61 ± 1.26 vs. 1.08 ± 1.35 mm2, p = 0.015).
The DCL was proved to increase thrombosis, fibrosis, and stenosis in the SVC. Likewise, the DCL was mechanically harder to be extracted than the SCL. Our study showed that lead-related complications of the DCLs were higher than those of the SCLs regardless of the equal defibrillation thresholds between them. Results of the present study would help to choose the proper lead which could be removed.
KeywordsSingle-coil lead Dual-coil lead Implantable cardioverter defibrillator Stenosis Fibrosis
All the defibrillation leads used in this experiment were generously provided by St. Jude Medical (Shanghai). Besides, we especially appreciate SQ Hou on giving modification of this article to improve its language.
Zq Yu participated in conception and design, animal experiment, acquisition of data, and drafting and revising the manuscript; Y Wu took part in study design, animal experiment, acquisition of data, and subsequent analysis as well as giving revised edition of the manuscript; Rz Chen carried out acquisition of data and statistical analysis; Jf Wang, Xy Chen, and Sm Qin took part in setting up animal model and acquisition of data; Jb Ge carried out design, having given final approval of the version to be published; Yg Su participated in study design and the implement of animal experiment, and having given final approval of the version to be published. All authors read and approved the final manuscript.
This study was supported by National Natural Science Foundation of China (Grant No: 81671934), Science and Technology Commission of Shanghai Municipality (Grant No: 17140902400), and Zhongshan Hospital Science Funding (Grant No: fund-044).
Compliance with ethical standards
The authors declare that they have no competing interests.
This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University.
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