左室四极起搏导线在心脏再同步治疗中的应用

The application of quadripolar LV Lead in cardiac resynchronization therapy

目的初步评估左心室四极导线的安全性和有效性。方法入选符合心脏再同步治疗(CRT)适应证的患者,植入应用左心室四极导线的心脏再同步除颤器(CRT-D)。评估其安全性和急性期疗效。结果 2例患者均通过静脉途径成功植入CRT-D装置,仅1例在头端(第1极)起搏测试时有膈神经刺激,未出现其他手术并发症。程控发现,优化的起搏向量下,2例患者的QRS时限和心脏同步性均最佳,左室射血分数改善。结论初步的应用结果表明,左心室四极导线在减少相关并发症的同时,提高CRT急性期疗效。

Objective To explore the safety and effectiveness of quadripolar left ventricular Lead in cardiac resynchronization therapy （CRT）. Methods Patients who meet the indications for CRT were enroUed in this study, and received cardiac resynchronization therapy defibrillator （CRT-D） device with quadripolar left ventficular Lead. The safety and efficacy of quadripolar left ventricular Lead were then evaluated. Results The devices of CRT-D were implanted using the venous access approaches in 2 patients. Phrenic nerve stimulation was only associated with pacing from the distal tip electrode in 1 patient. Other complications didn＇t occur. Optimized pacing vector get narrowest QRS duration and cardiac synchronization, LVEF were also improved in the 2 patient. Conclusions Preliminary results remind that the benefit of quadripolar left ventricular Lead include fewer complications and further improvement of acute efficacy in patient with CRT-D.