[微创左心室心外膜导线置入用于心脏再同步治疗的疗效]

[Efficacy of minimally invasive left ventricular epicardial lead placement for cardiac resynchronization therapy].

作者信息

Wang Yun-long, Ren Xue-jun, Li Wen-bin, Xie Jin-sheng, Jiang Teng-yong, Han Zhi-hong, Chen Fang, Guo Ji-hong

机构信息

Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Jul;38(7):614-7.

PMID:21055284

Abstract

OBJECTIVE

Ventricular resynchronization might be achieved via minimally invasive left ventricular epicardial lead placement.

METHOD

Six patients with congestive heart failure underwent minimally invasive left ventricular epicardial lead placement after failed coronary sinus cannulation were followed up for 1 year, cardiac function and LV lead threshold were evaluated.

RESULTS

There were no in-hospital deaths, intraoperative complications and diaphragm stimulation. Correct lead positioning was achieved in all 6 patients. LV lead thresholds remained unchanged [(1.2 ± 0.5) V vs (1.1 ± 0.4) V, P = 0.68] at 12 months follow-up. Improvements on 6 min walking test [(327 ± 77) m vs (267 ± 68) m, P = 0.001], LVEF [(26.1 ± 6.0)% vs (38.2 ± 4.7)%, P = 0.004], and NYHA functional class were evidenced at 12 months follow-up.

CONCLUSION

Minimally invasive left ventricular epicardial lead placement is a safe and reliable technique and should be considered as an alternative option in case of difficult coronary venous anatomy and inability to position the lead for resynchronization therapy.

摘要

目的

通过微创左心室心外膜导线置入可能实现心室再同步化。

方法

6例充血性心力衰竭患者在冠状窦插管失败后接受微创左心室心外膜导线置入，随访1年，评估心功能和左心室导线阈值。

结果

无院内死亡、术中并发症及膈肌刺激。6例患者均实现导线正确定位。随访12个月时左心室导线阈值保持不变[（1.2±0.5）V对（1.1±0.4）V，P=0.68]。随访12个月时6分钟步行试验[（327±77）m对（267±68）m，P=0.001]、左心室射血分数[（26.1±6.0）%对（38.2±4.7）%，P=0.004]及纽约心脏协会功能分级均有改善。