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Malaty MM, Sivagangabalan G, Qian PC. Beyond Conventional Cardiac Resynchronisation Therapy: A Review of Electrophysiological Options in the Management of Chronic Heart Failure. Heart Lung Circ 2023; 32:905-913. [PMID: 37286460 DOI: 10.1016/j.hlc.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 06/09/2023]
Abstract
The incidence of heart failure (HF) continues to grow and burden our health care system. Electrophysiological aberrations are common amongst patients with heart failure and can contribute to worsening symptoms and prognosis. Targeting these abnormalities with cardiac and extra-cardiac device therapies and catheter ablation procedures augments cardiac function. Newer technologies aimed to improvement procedural outcomes, address known procedural limitations and target newer anatomical sites have been trialled recently. We review the role and evidence base for conventional cardiac resynchronisation therapy (CRT) and its optimisation, catheter ablation therapies for atrial arrhythmias, cardiac contractility and autonomic modulation therapies.
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Affiliation(s)
- Michael M Malaty
- Department of Cardiology, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Gopal Sivagangabalan
- Department of Cardiology, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia; School of Medicine, Sydney Campus, University of Notre Dame, Sydney, NSW, Australia
| | - Pierre C Qian
- Department of Cardiology, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.
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2
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Shivamurthy P, Miller MA, El-Eshmawi A, Boateng P, Pandis D, Pawale A, Leviner DB, Costa AC, Rimsukcharoenchai C, Weiner MM, Salter B, Montgomery ML, Anyanwu A, Adams DH. Leadless pacemaker implantation under direct visualization during valve surgery. J Thorac Cardiovasc Surg 2020; 163:1818-1825. [PMID: 32891452 DOI: 10.1016/j.jtcvs.2020.07.092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The leadless cardiac pacemaker is typically implanted percutaneously and has been widely used for patients who have already undergone valve surgery. We sought to determine the feasibility and safety of implanting the leadless pacemaker under direct visualization during valve surgery. METHODS We performed a retrospective analysis of consecutive adult patients (n = 15) who underwent implantation of a leadless pacemaker under direct visualization at the time of valve surgery. Indications for single-chamber pacing were sick sinus syndrome with pauses (53.3%), atrial fibrillation with slow ventricular rates (13.3%) or complete heart block (6.6%), and elevated risk for postoperative heart block (26.6%). Leadless pacemaker performance and pacing percentage were assessed. RESULTS Patients' age was 67.5 ± 17 years, 6 patients (40%) were male, and 14 patients (93%) had atrial fibrillation. Isolated tricuspid valve replacement was performed in 5 patients (33.3%), and the remainder underwent multivalve surgery that included concomitant tricuspid valve repair/replacement. In 93% of the patients (n = 14), the immediate post-cardiopulmonary bypass pacing thresholds were normal (≤2.0 V at 0.24 ms) and normalized in the remaining patient by the next morning. The impedance/sensing values were normal and stable through follow-up (151 ± 119 days) in all patients. Reliable leadless pacemaker performance allowed for deferral of temporary epicardial wires in 11 patients (73%). There were no procedural complications or device malfunction. CONCLUSIONS Leadless cardiac pacemaker implantation during valve surgery is feasible and safe. This hybrid approach to pacing may simplify the perioperative management of patients undergoing valve surgery who have an indication for single-chamber pacing.
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Affiliation(s)
- Poojita Shivamurthy
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Marc A Miller
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ahmed El-Eshmawi
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Percy Boateng
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dimosthenis Pandis
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amit Pawale
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dror B Leviner
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana Claudia Costa
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Menachem M Weiner
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Benjamin Salter
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Morgan L Montgomery
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anelechi Anyanwu
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David H Adams
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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Alves Silva LA, de Souza Meira EB, Curimbaba J, Pimenta JA. Coronary Sinus Phlebography in Cardiac Resynchronization Therapy Patients: Identifying and Solving Demanding Cases. J Innov Card Rhythm Manag 2020; 11:4161-4170. [PMID: 32724707 PMCID: PMC7377645 DOI: 10.19102/icrm.2020.110703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/24/2020] [Indexed: 11/06/2022] Open
Abstract
Cardiac resynchronization therapy (CRT) improves symptoms and reduces morbidity and mortality in select heart failure patients but remains challenging to deploy widely because of difficult or unsuccessful coronary sinus (CS) access in up to 10% to 15% of patients. This report describes the radiological and anatomical aspects for improving CS catheterization and left ventricular (LV) lead positioning, focusing on the radioscopic and anatomical aspects, based on phlebography, to identify demanding cases in patients with dilated cardiomyopathy referred for CRT implantation. Anatomical and radiological aspects were explored in the anteroposterior, 30° left anterior oblique, and 30° right anterior oblique (RAO) views. In total, 117 phlebographies were performed in 39 consecutive procedures (one reintervention). Access to the CS was successful 37 times (94.9%). The most difficult cases were complicated by issues related to the altered spatial orientation of the CS ostium toward the tricuspid annular plane (TAP), which was best perceived in the 30° RAO projection and occurred in 37% of patients. One of two catheterization failures that occurred was caused by anomalous coronary venous drainage into the left atrium. Final LV lead positioning was successful in 36 (92.3%) of 39 procedures. More severe heart failure and worse LV ejection fraction did not translate into greater difficulty in LV lead implantation. As such, understanding anatomical and radiological relationships is the key to successful LV lead positioning. RAO projection can be particularly useful in the assessment of demanding CRT implant cases, especially when the CS ostium pointed to the TAP.
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Affiliation(s)
- Lenine Angelo Alves Silva
- Division of Cardiovascular System, Hospital Universitário Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | - Jefferson Curimbaba
- Division of Cardiology, IAMSPE-Hospital do Servidor Público Estadual, São Paulo, Brazil
| | - João A Pimenta
- Division of Cardiology, IAMSPE-Hospital do Servidor Público Estadual, São Paulo, Brazil
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4
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Lau EW. Multi-site multi-polar left ventricular pacing through persistent left superior vena cava in tricuspid valve disease. Indian Pacing Electrophysiol J 2017; 17:156-159. [PMID: 29192594 PMCID: PMC5652279 DOI: 10.1016/j.ipej.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/25/2017] [Accepted: 05/29/2017] [Indexed: 11/26/2022] Open
Abstract
Multi-site multi-polar left ventricular pacing through the coronary sinus (CS) may be preferred over endocardial right ventricular or surgical epicardial pacing in the presence of tricuspid valve disease. However, the required lead placement can be difficult through a persistent left superior vena cava (PLSVC), as the CS tends to be hugely dilated and side branches tend to have sharp angulations (>90°) when approached from the PLSVC. Pre-shaped angiography catheters and techniques used for finding venous grafts from the ascending aorta post coronary bypass surgery may help with lead placement in such a situation.
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Affiliation(s)
- Ernest W Lau
- Department of Cardiology, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
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Reddy VY, Miller MA, Neuzil P, Søgaard P, Butter C, Seifert M, Delnoy PP, van Erven L, Schalji M, Boersma LV, Riahi S. Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing. J Am Coll Cardiol 2017; 69:2119-2129. [DOI: 10.1016/j.jacc.2017.02.059] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
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6
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Newcomb A. Wire Externalisation for Left Ventricular Lead Placement in Cardiac Resynchronisation Therapy: A Step-by-step Guide. Heart Lung Circ 2016; 25:1041. [PMID: 26948767 DOI: 10.1016/j.hlc.2016.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/12/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Andrew Newcomb
- Director Cardiothoracic Surgery, St Vincent's Melbourne, PO Box 2900, 41 Victoria Parade, Fitzroy VIC 3065.
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Buiten MS, van der Heijden AC, Klautz RJ, Schalij MJ, van Erven L. Epicardial leads in adult cardiac resynchronization therapy recipients: A study on lead performance, durability, and safety. Heart Rhythm 2015; 12:533-539. [DOI: 10.1016/j.hrthm.2014.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Indexed: 01/17/2023]
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8
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Gamble JHP, Betts TR. Multisite left ventricular pacing in cardiac resynchronization therapy. Future Cardiol 2014; 10:469-77. [PMID: 25301310 DOI: 10.2217/fca.14.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cardiac resynchronization therapy is an effective treatment for selected patients with heart failure and left bundle branch block dyssynchrony. Unfortunately, about a third of patients, so-called nonresponders, do not display any symptomatic or structural improvements after the treatment. In another 5% of patients, the left ventricular lead cannot be implanted due to technical limitations. Novel quadripolar pacing lead and associated multisite pacing technology has the potential to help improve both of these problems. The technology and applications of these leads are reviewed and the novel technique of multisite pacing from two poles of one quadripolar lead is discussed. This technology may improve response to cardiac resynchronization therapy for some patients.
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Affiliation(s)
- James H P Gamble
- Oxford Heart Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
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9
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MIHALCZ ATTILA, KASSAI IMRE, GELLER LASZLO, SZILI-TÖRÖK TAMAS. Alternative Techniques for Left Ventricular Pacing in Cardiac Resynchronization Therapy. Pacing Clin Electrophysiol 2013; 37:255-61. [DOI: 10.1111/pace.12320] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 09/26/2013] [Accepted: 10/13/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - IMRE KASSAI
- Hungarian National Institute of Cardiology; Budapest Hungary
| | - LASZLO GELLER
- Heart Center; Semmelweis University; Budapest Hungary
| | - TAMAS SZILI-TÖRÖK
- Department of Clinical Cardiac Electrophysiology; Thorax Centre; Rotterdam the Netherlands
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10
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Shan L, Buratto E, Conaglen P, Davis P, Yii M, Nixon I, Newcomb A. Prophylactic epicardial left ventricular lead implantation for biventricular pacing during operations. Ann Thorac Surg 2013; 97:603-8. [PMID: 24206965 DOI: 10.1016/j.athoracsur.2013.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/30/2013] [Accepted: 09/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Surgical epicardial left ventricular (LV) lead implantation for biventricular pacing has advantages over the transvenous approach in cardiac surgical patients. We investigated the benefit of concomitant prophylactic LV lead implantation during open heart operations and subsequent lead performance after patients with impaired LV function receive a biventricular device. METHODS Retrospective data of 4,844 patients undergoing cardiac operations through a sternotomy between January 2001 and December 2011 were analyzed. Of these, 380 patients (7.8%) had severe impairment of LV function (contrast left ventriculogram showing grade 4 estimated ejection fraction or echocardiogram showing LV ejection fraction<0.30). LV lead implantation was performed in patients in whom recovery of LV function was unlikely. Lead performance data were collected at follow-up. RESULTS LV lead implantation occurred in 95 patients (25%), and 29 (30.5%) subsequently received a biventricular device. Of patients with impaired LV function, more patients with prophylactic LV leads underwent biventricular implant than those without LV leads (30.5% vs 1.1%, p<0.0001). The median interval from LV lead implantation to connection to a biventricular device was 30 days (interquartile range, 5.5 to 145 days). At a median follow-up of 437.5 days (interquartile range, 13.8 to 1198 days), the mean pacing threshold (1.25±0.46 vs 1.58±0.66 volts, p=0.069) and impedance (383.81±70.33 vs 448.6±200.1 Ohms, p=0.168) remained stable compared with time of biventricular device connection. CONCLUSIONS A significant proportion of patients with poor LV function undergoing cardiac operations may benefit from concomitant LV lead implantation. Subsequent lead performance appears satisfactory. Epicardial LV lead placement is easily accomplished during open heart operations and should be considered before the operation.
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Affiliation(s)
- Leonard Shan
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
| | - Edward Buratto
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Paul Conaglen
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Philip Davis
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Michael Yii
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Ian Nixon
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Andrew Newcomb
- Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; University of Melbourne Department of Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
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11
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Sankaranarayanan R, Visweswariah R, Fox DJ. New developments in cardiac resynchronization therapy. Br J Hosp Med (Lond) 2013; 74:503-9. [DOI: 10.12968/hmed.2013.74.9.503] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rajiv Sankaranarayanan
- Electrophysiology and British Heart Foundation Clinical Research Fellow University Hospital South Manchester and University of Manchester, Manchester M23 9LT
| | | | - David J Fox
- Department of Cardiology, University Hospital South Manchester, Manchester
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12
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Gardini A, Fracassi F, Saporetti A, Mariggio D. Reconstruction of the Terminal of an Abandoned Fractured Unipolar Coronary Sinus Lead: a Feasible Solution to Restore Effective Cardiac Resynchronization Therapy. Indian Pacing Electrophysiol J 2013; 13:122-5. [PMID: 23840107 PMCID: PMC3691391 DOI: 10.1016/s0972-6292(16)30630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Complications related to coronary sinus lead are not infrequent in recipients of cardiac resynchronization devices. We describe the case of a patient with a biventricular implantable cardioverter defibrillator with persistent phrenic nerve stimulation, previous coronary sinus lead fracture, and severe left subclavian vein stenosis. The reimplantation of a new coronary sinus lead on the left side, ipsilateral to the original implant, was unsuccessful. In order to avoid more complex and risky procedures, we performed the repair of the fractured abandoned lead with the reconstruction of the unipolar lead terminal. Effective biventricular pacing was obtained with satisfactory electrical parameters and it was maintained at twelve months follow-up.
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13
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Snare coupling of the pre-pectoral pacing lead delivery catheter to the femoral transseptal apparatus for endocardial cardiac resynchronization therapy. J Interv Card Electrophysiol 2012. [DOI: 10.1007/s10840-012-9734-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Elencwajg B, López Cabanillas N, Cardinali EL, Barisani JL, Trainini J, Fischer A, Worley S. The Jurdham procedure: Endocardial left ventricular lead insertion via a femoral transseptal sheath for cardiac resynchronization therapy pectoral device implantation. Heart Rhythm 2012; 9:1798-804. [PMID: 22810022 DOI: 10.1016/j.hrthm.2012.07.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Indexed: 10/28/2022]
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15
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DESIMONE CHRISTOPHERV, DESIMONE DANIELC, HAGLER DONALDJ, FRIEDMAN PAULA, ASIRVATHAM SAMUELJ. Cardioembolic Stroke in Patients with Patent Foramen Ovale and Implanted Cardiac Leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 36:50-4. [DOI: 10.1111/pace.12014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/26/2012] [Accepted: 08/14/2012] [Indexed: 11/29/2022]
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16
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Percutaneous Coronary Sinus Interventions to Facilitate Implantation of Left Ventricular Lead: A Case Series and Review of Literature. J Card Fail 2012; 18:321-9. [DOI: 10.1016/j.cardfail.2012.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 11/17/2011] [Accepted: 01/03/2012] [Indexed: 11/18/2022]
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Szilágyi S, Merkely B, Molnár L, Zima E, Osztheimer I, Végh EM, Gellér L. CRT implantation: Lead stabilization using coronary sinus side branch stenting. Interv Med Appl Sci 2011. [DOI: 10.1556/imas.3.2011.3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Objective
We describe a method to stabilize CS lead position using stent implantation in a CS side branch to anchor the electrode to the wall of the vein, in cases of intraoperative or postoperative lead dislocation, unstable lead position and phrenic nerve stimulation (PNS).
Methods
403 patients were treated with stenting. After finding the desired lead position bare metal coronary stent was introduced via another guide wire, but in the same CS sheath. The stent was deposited 5–35 mm proximal to the tip of the electrode with a pressure of 6 to 14 atmospheres.
Results
Mechanical damage of the CS side branch or pericardial effusion was not observed. During follow-up (median 39, 23–48, max. 82 months) re-operation was necessary in only two patients because of high pacing threshold, while repositioning with ablation catheter was performed in 7 cases because of PNS. Impedance measurements did not suggest lead insulation failure. Transvenous extraction of stented CS leads was successful after 3, 18 and 49 months, while 4 leads were extracted easily during heart transplantation.
Conclusion
Stent implantation to stabilize CS lead position seems to be effective and safe for the prevention and treatment of CS lead dislocation in special cases.
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Affiliation(s)
- Sz. Szilágyi
- 1 Heart Center, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- 1 Heart Center, Semmelweis University, Budapest, Hungary
- 2 Heart Center, Semmelweis University, Városmajor u. 68, H-1122, Budapest, Hungary
| | - L. Molnár
- 1 Heart Center, Semmelweis University, Budapest, Hungary
| | - E. Zima
- 1 Heart Center, Semmelweis University, Budapest, Hungary
| | - I. Osztheimer
- 1 Heart Center, Semmelweis University, Budapest, Hungary
| | - E. M. Végh
- 1 Heart Center, Semmelweis University, Budapest, Hungary
| | - L. Gellér
- 1 Heart Center, Semmelweis University, Budapest, Hungary
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Gellér L, Szilágyi S, Zima E, Molnár L, Széplaki G, Végh EM, Osztheimer I, Merkely B. Long-term experience with coronary sinus side branch stenting to stabilize left ventricular electrode position. Heart Rhythm 2011; 8:845-50. [DOI: 10.1016/j.hrthm.2011.01.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 01/06/2011] [Indexed: 10/18/2022]
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LAU ERNESTW. Yoked Catheter Positioning in Transseptal Endocardial Left Ventricular Lead Placement. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:884-93. [DOI: 10.1111/j.1540-8159.2011.03069.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Bibliography. Current world literature. Thoracic anesthesia. Curr Opin Anaesthesiol 2011; 24:111-3. [PMID: 21321525 DOI: 10.1097/aco.0b013e3283433a20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zhao X, Burger M, Liu Y, Das MK, Combs W, Wenk JF, Guccione JM, Kassab GS. Simulation of LV Pacemaker Lead in Marginal Vein: Potential Risk Factors for Acute Dislodgement. J Biomech Eng 2011; 133:031006. [DOI: 10.1115/1.4003323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although left ventricular (LV) coronary sinus lead dislodgement remains a problem, the risk factors for dislodgement have not been clearly defined. In order to identify potential risk factors for acute lead dislodgement, we conducted dynamic finite element simulations of pacemaker lead dislodgement in marginal LV vein. We considered factors such as mismatch in lead and vein diameters, velocity of myocardial motion, branch angle between the insertion vein and the coronary sinus, degree of slack, and depth of insertion. The results show that large lead-to-vein diameter mismatch, rapid myocardial motion, and superficial insertion are potential risk factors for lead dislodgement. In addition, the degree of slack presents either a positive or negative effect on dislodgement risk depending on the branch angle. The prevention of acute lead dislodgment can be enforced by inducing as much static friction force as possible at the lead-vein interface, while reducing the external force. If the latter exceeds the former, dislodgement will occur. The present findings underscore the major risk factors for lead dislodgment, which may improve implantation criterion and future lead design.
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Affiliation(s)
- Xuefeng Zhao
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202
| | - Mike Burger
- Livermore Software Technology Corporation, Livermore, CA 94550
| | - Yi Liu
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202
| | - Mithilesh K. Das
- Krannert Institute of Cardiology, Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN 46202
| | - William Combs
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202
| | - Jonathan F. Wenk
- Department of Surgery and San Francisco VA Medical Center, University of California at San Francisco, San Francisco, CA 94121
| | - Julius M. Guccione
- Department of Surgery and San Francisco VA Medical Center, University of California at San Francisco, San Francisco, CA 94121
| | - Ghassan S. Kassab
- Department of Surgery, and Department of Cellular and Integrative Physiology, Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202
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DEMIR AHMETDURAN, CAY SERKAN, ERBAY ALIRIZA, MADEN ORHAN, ATAK RAMAZAN, BALBAY YUCEL. Long-Term Follow-Up Data of Coronary Sinus Stenting for the Stabilization of the Left Ventricular Leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 33:1485-9. [DOI: 10.1111/j.1540-8159.2010.02894.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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BONGIORNI MARIAGRAZIA, DI CORI ANDREA, ZUCCHELLI GIULIO, SEGRETI LUCA, DE LUCIA RAFFAELE, PAPERINI LUCA, SOLDATI EZIO. A Modified Transvenous Single Mechanical Dilatation Technique to Remove a Chronically Implanted Active-Fixation Coronary Sinus Pacing Lead. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 34:e66-9. [DOI: 10.1111/j.1540-8159.2010.02784.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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