Department of Electrophysiology, University of Leipzig, Heart Center, Strümpellstrasse 39, Leipzig, Germany.
Eur J Heart Fail. 2010 Apr;12(4):411-4. doi: 10.1093/eurjhf/hfq013. Epub 2010 Feb 11.
A 78-year-old woman with dilated cardiomyopathy was admitted for advanced dyspnoea and recurrent cardiac decompensation despite optimal medical therapy. Implantation of a cardiac resynchronization therapy (CRT) device was indicated according to current guidelines. The day before CRT implantation, three-dimensional echocardiography was performed together with coronary sinus (CS) rotation angiography, which identified two sites of latest mechanical left ventricular (LV) contraction with adjacently available target veins. This case presents the first description of CRT target vein selection using a combination of functional information on LV contraction with anatomical information on the CS venous tree. In this specific patient, the approach eventually necessitated placement of two LV leads.
一位 78 岁的女性因扩张型心肌病导致呼吸困难加重和心脏反复失代偿而入院，尽管接受了最佳的药物治疗。根据当前的指南，建议植入心脏再同步治疗（CRT）装置。在 CRT 植入前一天，进行了三维超声心动图检查和冠状窦（CS）旋转血管造影，确定了两个具有相邻可用靶静脉的左心室（LV）最晚机械收缩部位。本病例首次描述了使用 LV 收缩的功能信息与 CS 静脉树的解剖信息相结合来选择 CRT 靶静脉的方法。在这个特定的患者中，该方法最终需要放置两个 LV 导联。
