Li Yao-dong, Li Jin-xin, Zhou Xian-hui, Tang Bao-peng, Zhang Yu, Zhang Jiang-hua
Heart Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Jan;41(1):65-8.
To summarize application experience of attain ® select II catheter delivery system for left ventricular lead implantation in cardiac resynchronization therapy (CRT).
CRT/CRT-D was applied for 86 patients with congestive heart failure and left bundle-branch block. Left ventricular lead implantation was applied without use of attain ® select II catheter delivery system in 42 patients without coronary vein anatomy variation (group A). Coronary sinus and cardiac vein angiography detected coronary vein anatomy variations in 44 patients and attain ® select II catheter delivery system was not used in 21 patients (group B) and used in 23 patients (group C). Total procedure time, LV lead implantation time, X-ray exposure time and complications were compared among groups. The optimal LV lead location were observed at the end of procedure.
Patients were followed up to 245 days (160 - 368 days). Total procedure time [(119 ± 18) min vs. (142 ± 17) min; (119 ± 18) min vs. (143 ± 17) min], LV lead implantation time [(32 ± 7) min vs. (49 ± 8) min;(32 ± 7) min vs. (51 ± 7) min]and X-ray exposure time [(27 ± 6) min vs. (46 ± 84) min;(27 ± 6) min vs. (45 ± 7) min] were significant reduced in group C compared to group A and B. Procedure-related complications were similar among the 3 groups. The rate of optimal LV lead location was significantly higher in group C than in group B (96% vs. 71%).
It is feasible and safe to implant LV lead through coronary sinus with attain ® select II catheter delivery system. Applying Attain ® select II catheter delivery system can improve the rate of optimal LV lead location with coronary venous anatomy variation.
总结Attain® Select II导管输送系统在心脏再同步治疗（CRT）左心室导线植入中的应用经验。
对86例充血性心力衰竭合并左束支传导阻滞患者进行CRT/CRT-D治疗。42例无冠状静脉解剖变异的患者未使用Attain® Select II导管输送系统进行左心室导线植入（A组）。44例患者经冠状窦和心脏静脉造影检测到冠状静脉解剖变异，其中21例未使用Attain® Select II导管输送系统（B组），23例使用该系统（C组）。比较三组的总手术时间、左心室导线植入时间、X线暴露时间及并发症。手术结束时观察左心室导线的最佳位置。
患者随访至245天（160 - 368天）。与A组和B组相比，C组的总手术时间[（119±18）分钟对（142±17）分钟；（119±18）分钟对（143±17）分钟]、左心室导线植入时间[（32±7）分钟对（49±8）分钟；（32±7）分钟对（51±7）分钟]和X线暴露时间[（27±6）分钟对（46±84）分钟；（27±6）分钟对（45±7）分钟]显著缩短。三组手术相关并发症相似。C组左心室导线最佳位置的发生率显著高于B组（96%对71%）。
使用Attain® Select II导管输送系统经冠状窦植入左心室导线是可行且安全的。应用Attain® Select II导管输送系统可提高存在冠状静脉解剖变异时左心室导线最佳位置的发生率。
