Department of Cardiovascular Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
Europace. 2010 Nov;12(11):1600-3. doi: 10.1093/europace/euq318. Epub 2010 Sep 6.
Stenosis in the coronary veins can cause the failure of left ventricular (LV) lead implantation, which is the cornerstone of cardiac resynchronization therapy (CRT). There are several cases in which LV pacing could be possible after successful elimination of coronary vein stenosis by coronary vein angioplasty. The study was conducted to investigate the efficacy of coronary vein angioplasty with an aim to a facilitate implantation of LV lead.
Transvenous LV leads were implanted in 118 consecutive patients from November 2001 to January 2009. Retrospective analysis performed by the CRT system showed that 3 of 118 patients (2.54%) needed coronary vein angioplasty to facilitate the lead placement. Each target vein was successfully dilated by using coronary balloon angioplasty catheters of 2.5 mm (2 patients) and 3.0 mm (1 patient). Then the LV leads could be inserted and there were no complications.
Coronary vein angioplasty is an effective and safe technique to make transvenous LV pacing lead insertion a possibility in case of target vein stenoses.
冠状静脉狭窄可导致左心室（LV）导联植入失败，这是心脏再同步治疗（CRT）的基石。有几例病例，通过冠状静脉成形术成功消除冠状静脉狭窄后，LV 起搏是可行的。本研究旨在探讨冠状静脉成形术的疗效，以促进 LV 导联的植入。
2001 年 11 月至 2009 年 1 月，连续 118 例患者接受了经静脉 LV 导联植入术。通过 CRT 系统进行回顾性分析显示，有 3 例（2.54%）患者需要冠状静脉成形术以方便导联放置。每个靶静脉均通过 2.5mm（2 例）和 3.0mm（1 例）的冠状动脉球囊成形术导管成功扩张。然后可以插入 LV 导联，且无并发症发生。
在靶静脉狭窄的情况下，冠状静脉成形术是一种有效且安全的技术，可以使经静脉 LV 起搏导联的插入成为可能。
