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Use of the Attain Select Ⅱ catheter delivery system to improve left ventricular lead implantation in cardiac resynchronization therapy
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作者 ZHOU Xian-hui TANG Bao-peng LI Jin-xin ZHANG Yu ZHANG Jiang-hua LI Yao-dong 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第8期1209-1212,共4页
Background Despite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronar... Background Despite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac vein.Methods Totally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular (LV) lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select Ⅱ catheter delivery system. The patients were seen every 3-6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were evaluated.Results There were no significant differences in the age, gender, New York Heart Association (NYHA) functional class,ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select Ⅱ catheter delivery system; LV lead implantation time from (51-7) minutes to (40±7) minutes (P <0.001), procedure time from (143±17) minutes to (124±18)minutes (P=0.001), and fluoroscopy time from (45±7) minutes to (35±6) minutes (P<0.001). A successful procedure of LV lead implantation was significantly improved from 17/23 (74%) patients using the standard techniques and equipment, to 20/21 (95.3%) patients using the Attain Select Ⅱ catheter delivery system (P=0.06)Conclusion It is feasible and safe to implant LV leads through the coronary sinus using the Attain Select Ⅱ catheter delivery system. 展开更多
关键词 cardiac resynchronization therapy congestive heart failure the attain select catheter delivery system left ventricular lead implantation
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鞘中鞘技术在心脏再同步化治疗中的应用及评价 被引量:1
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作者 李耀东 李晋新 +3 位作者 周贤惠 汤宝鹏 张宇 张疆华 《中华心血管病杂志》 CAS CSCD 北大核心 2013年第1期65-68,共4页
目的评价鞘中鞘技术在心脏再同步化治疗(CRT)患者左心室电极导线置入中的应用。方法回顾性分析86例慢性心力衰竭伴完全性左束支传导阻滞成功置入CRT或CRT—D患者。对42例患者无冠状静脉解剖变异未应用鞘中鞘技术置入左心室电极(A组)... 目的评价鞘中鞘技术在心脏再同步化治疗(CRT)患者左心室电极导线置入中的应用。方法回顾性分析86例慢性心力衰竭伴完全性左束支传导阻滞成功置入CRT或CRT—D患者。对42例患者无冠状静脉解剖变异未应用鞘中鞘技术置入左心室电极(A组),21例患者存在冠状静脉解剖变异未应用鞘中鞘技术(B组)和23例患者存在冠状静脉解剖变异应用鞘中鞘技术(C组)置入左心室电极的总的手术操作时间、左心室电极置入时间、X线曝光时间及并发症发生率进行比较。并对三组患者根据冠状静脉造影选择左心室电极置入靶静脉解剖最佳位置进行比较。结果平均随访245d(随访时间160~368d),C组与A、B组比较,左心室电极技术总的手术操作时间[(119±18)min比(142±17)min;(119±18)min比(143±17)min]、左心室电极置入时间[(32±7)min比(49±8)min;(32±7)min比(51±7)min]、X线曝光时间[(27±6)rain比(46±84)min;(27±6)min比(45±7)min]缩短,有统计学差异;并发症发生率三组间未见明显差异。靶静脉最佳解剖位置C与B两组间比较(96%比71%),差异有统计学意义。结论通过鞘中鞘技术置入左心室电极是安全可行的,并且对存在冠状静脉解剖变异可提高靶静脉最佳位置到位率。 展开更多
关键词 心脏导管插入术 心脏再同步化治疗 鞘中鞘输送系统
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