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T. Zerah, G. Zerah, H. Sitbon, 11. Cardiac Resynchronization Therapy: Different Issues: 11.6 Cardiac Resynchronization: Feasability of a Simplified Procedure, EP Europace, Volume 7, Issue s3, 2005, Page S18, https://doi.org/10.1016/j.eupc.2005.08.175
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Abstract
Multisite pacing procedures are X-ray andtime consuming and difficult. Our aim was to determine whether a simple procedure is effective, safe and faster. A coronary sinus (CS) angiography is performed prior to implantation. Even with thin or twisted target vein, we tried to catheterize directly CS and target vein using different stylets type and curves. The lead choice (OTW or standard) was discussed before each procedure. In case of failure, the standard procedure (sheath ± angioplasty guide wire) was tried.
27 pts were evaluated from 05-04 to 12-04. The target vein size was thin with 7 pts, medium with 11 pts and large with 9 pts. An OTW lead was chosen for 8 pts. 2 pts failed to be implanted with both techniques and 2 pts were implanted using the standard procedure. The direct SC lead positioning was successful in 25/27. LV threshold: 1.23±0.8V, LV wave amplitude: 15.2±7mV, LV impedance: 820±330Ohms, and procedure time: 70±30min. 3 early lead dislodgments had required a repositioning.
In a majority of cases (85%), this simplified procedure is safe and faster than standard procedures even when the target vein seems to be small.
