Stockburger M
Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Medizinische Klinik mit Schwerpunkt Kardiologie, Augustenburger Platz 1, 13353 Berlin.
Herzschrittmacherther Elektrophysiol. 2006;17 Suppl 1:I20-7. doi: 10.1007/s00399-006-1104-x.
Cardiac resynchronization with or without antitachycardiac treatment is now an established option to improve the functional status, morbidity and mortality of patients with severe symptomatic systolic heart failure, ventricular conduction delay and asynchrony. Increasing implant numbers are to be expected. The transvenous left ventricular lateral lead placement can now be achieved in up to 97% of patients. But due to the coronary venous anatomy it may still constitute a challenge even for experienced pacemaker and ICD implanters. In addition, it confers a considerable risk for complications like coronary sinus dissection and perforation, diaphragmatic stimulation and lead dislodgement. An overview is given on possible technical problems, solutions, complications and preventive strategies.
伴有或不伴有抗心动过速治疗的心脏再同步化治疗现已成为改善重症有症状收缩性心力衰竭、心室传导延迟和不同步患者功能状态、发病率及死亡率的既定选择。预计植入数量会不断增加。目前，高达97%的患者可实现经静脉左心室侧壁导线置入。但由于冠状静脉解剖结构的原因，即使对于经验丰富的起搏器和植入式心律转复除颤器植入者而言，这仍可能构成挑战。此外，它还会带来诸如冠状窦夹层和穿孔、膈肌刺激及导线脱位等相当大的并发症风险。本文对可能出现的技术问题、解决方案、并发症及预防策略进行了综述。
