使用 Attain Select II 导管输送系统来改善。

Use of the Attain Select II catheter delivery system to improve.

机构信息

Heart Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

Chin Med J (Engl). 2011 Apr;124(8):1209-12.

Abstract

BACKGROUND

Despite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac vein.

METHODS

Totally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular (LV) lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select II catheter delivery system. The patients were seen every 3 - 6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were evaluated.

RESULTS

There were no significant differences in the age, gender, New York Heart Association (NYHA) functional class, ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select II catheter delivery system; LV lead implantation time from (51 ± 7) minutes to (40 ± 7) minutes (P < 0.001), procedure time from (143 ± 17) minutes to (124 ± 18) minutes (P = 0.001), and fluoroscopy time from (45 ± 7) minutes to (35 ± 6) minutes (P < 0.001). A successful procedure of LV lead implantation was significantly improved from 17/23 (74%) patients using the standard techniques and equipment, to 20/21 (95.3%) patients using the Attain Select II catheter delivery system (P = 0.06)

CONCLUSION

It is feasible and safe to implant LV leads through the coronary sinus using the Attain Select II catheter delivery system.

摘要

背景

尽管在心脏再同步治疗（CRT）设备植入中使用的工具取得了技术进步，但仍存在许多障碍，主要与冠状动脉静脉解剖结构的变化有关。其中一个困难是外侧或后侧心静脉非常急剧地成角或扭曲。

方法

回顾性研究了 44 名充血性心力衰竭和室内传导延迟的患者，其中 28 名男性和 16 名女性。23 名患者使用标准技术和设备植入左心室（LV）导线。对于另外 21 名 LV 导线植入患者，我们使用了 Attain Select II 导管输送系统。患者在 12 个月内每 3-6 个月接受一次随访，评估两种技术的主要手术效果、LV 导线植入时间、手术和透视时间以及与两种技术相关的并发症。

结果

两组患者在年龄、性别、纽约心脏协会（NYHA）功能分级、缺血病因、QRS 持续时间、左心室射血分数、左心室舒张末期直径、左心室收缩末期直径和 LV 不同步方面无显著差异。使用 Attain Select II 导管输送系统的组 LV 导线植入时间、手术时间和透视时间明显缩短；LV 导线植入时间从（51±7）分钟缩短至（40±7）分钟（P＜0.001），手术时间从（143±17）分钟缩短至（124±18）分钟（P=0.001），透视时间从（45±7）分钟缩短至（35±6）分钟（P＜0.001）。使用标准技术和设备的 17/23（74%）患者的 LV 导线植入术成功，而使用 Attain Select II 导管输送系统的 20/21（95.3%）患者的 LV 导线植入术成功（P=0.06）。