左室起搏电极置入的实践经验

Study of Methodology That Could Elevate Success Rate of Left Ventricular Lead Implantation

探讨提高左室起搏电极的置入成功率,降低相关并发症的方法学及技术细节. 24例难治性心力衰竭患者,男16例、女8例,年龄59.5±7.8 (47～74)岁,所有患者均有双室起搏的适应证.按一定程序及方法置入导引导管及造影球囊导管.根据造影显示的冠状静脉解剖特点,选择合适的起搏电极、起搏静脉通路.结果: 左室起搏电极置入成功率91.7%(22/24).左室电极置入时间35.4±13.0 min,X线曝光时间19.4±5.2 min.所有手术均顺利完成,术中未发生死亡、心包压塞等严重并发症.结论:双室起搏时按照一定的程序及方法置入左室电极,既可提高置入成功率,又可降低并发症.

The objectives of this study was to investigate methodology as well as technique thatcould elevate the success rate of left ventricular（LV） lead implantation. Twenty-four patients（ 18 males ,6 females） with refractory heart failure were 59.5 ± 7.8 years old. All the patients had indication of biventricular pacing. In terms of the methodology and procedure, guiding catheter and angiography balloon catheter were implanted. Vein location and LV lead were selected by the results of venogram. Results： A success rate of LV lead implantation was 91.7% （22/24） , mean entire procedure and X ray exposure time were 35.4 ± 13.0 minutes, 19.4 ± 5.2 minutes, respectively. Procedures were completed perfectly in all patients, and serious complication did not take place. Conclusions：When left ventricular lead is implanted according to the methodology and procedure, success rate of left ventricular lead implantation elevated and complications decreased.