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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Effect of percutaneous interventions within the coronary sinus on the success rate of the implantations of resynchronization pacemakers.
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Effect of percutaneous interventions within the coronary sinus on the success rate of the implantations of resynchronization pacemakers.

机译：冠状窦内的经皮干预对再同步起搏器植入成功率的影响。

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BACKGROUND: Cardiac resynchronization therapy (CRT) becomes a "gold standard" in therapy of selected patients with advanced heart failure. We set out to evaluate the feasibility and safety of percutaneous interventions within coronary sinus (CS) and their effect on the success rate of left ventricular (LV) lead implantation during CRT. METHODS: The study analyzed eight consecutive patients with the indications for CRT, who needed additional procedures within CS to overcome technical problems during left ventricular (LV) electrode implantation. The analyzed group consisted of three subgroups: patients in whom percutaneous balloon angioplasty within CS was needed (n = 4); patients with acute instability of the lead, requiring stenting of the vein to fix the electrode (n = 2); and patients with the stenting of CS due to late dislocation of the lead (n = 2). Success rate, procedure duration, fluoroscopy, complications, and electrical parameters of leads were analyzed. RESULTS: Success rate of the procedures was 87.5%; additional interventions increased overall efficacy of CRT implantation at our center from 88% to 98% (P < 0.05). Procedure duration (155.0 minute) and fluoroscopy time (42.5 minute) remained acceptable for the patient and operator; however, both were higher than in the procedures performed routinely in our hospital. Electrical properties of the LV leads were stable and within normal ranges during the observation period. We noted two local dissections of CS during the procedure, which remained clinically silent. CONCLUSION: Percutaneous interventions within CS seem to be feasible and safe treatment options, which can improve the short- and long-term success rates of CRT.
机译：背景：心脏再同步治疗（CRT）成为某些晚期心力衰竭患者治疗的“金标准”。我们着手评估冠状窦（CS）内经皮介入治疗的可行性和安全性，以及它们对CRT期间左心室（LV）铅植入成功率的影响。方法：该研究分析了八位连续的CRT适应症患者，他们需要在CS内采取其他措施来克服左心室（LV）电极植入过程中的技术问题。分析组包括三个亚组：需要在CS内进行经皮球囊血管成形术的患者（n = 4）;铅急性不稳定的患者，需要将静脉置入支架以固定电极（n = 2）;以及因铅的晚期脱位而在CS内置入支架的患者（n = 2）。分析成功率，手术时间，荧光透视，并发症和导线的电学参数。结果：手术成功率为87.5％。其他干预措施将我们中心的CRT植入的总体疗效从88％提高到98％（P <0.05）。程序持续时间（155.0分钟）和透视检查时间（42.5分钟）仍然为患者和操作者所接受;但是，两者均高于我们医院常规执行的程序。在观察期间，LV引线的电性能稳定且在正常范围内。我们在手术过程中注意到了CS的两个局部解剖，但在临床上仍保持沉默。结论：CS内的经皮介入治疗似乎是可行和安全的治疗选择，可以提高CRT的短期和长期成功率。

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