Electrophysiology Catheter-Facilitated coronary sinus cannulation and implantation of cardiac resynchronization therapy systems.

摘要: Abstract Background Cardiac resynchronization therapy (CRT) device implantation is hampered by difficult placement of the left ventricular (LV) lead. We have routinely used a steerable electrophysiology catheter to guide coronary sinus (CS) cannulation and facilitate LV lead positioning. The aim this prospective study present our results with approach in 138 consecutive patients receiving CRT over 10 years. Methods included 120 men 18 women, aged 64.8±11.4 years, disease (n=63), cardiomyopathy (n=72), or other (n=3), mean ejection fraction 24.5±4.5%. Devices were implanted for refractory heart failure dyssynchrony, all but 2 presence bundle branch block. Implanted devices biventricular pacemakers (CRT-P) (n=33) cardioverter defibrillators (CRT-D) (n=105). Results Using catheter, CS could be engaged 134 (97.1%) patients. In 4 failing cannulation, dual-chamber was 2, bifocal right pacing effected 2. Bifocal (n=2) conventional (n=1) systems another 3 patients, whom got dislodged removed because local dissection (n=1). Thus, finally, system successfully established 131 (94.9%) There dissection, 1 complicated cardiac tamponade managed pericardiocentesis. no perioperative deaths. During follow-up (31.0±21.2 months), clinical improvement reported 108 (82.4%) Conclusion Routine use an greatly facilitated successful ∼95% undergoing implantation.