Exploring a New Systematic Route for Left Ventricular Pacing in Cardiac Resynchronization Therapy.
Circ J
; 85(3): 283-290, 2021 02 25.
Article
in En
| MEDLINE
| ID: mdl-33504741
ABSTRACT
BACKGROUND:
Frequency and distribution of left ventricular (LV) venous collaterals were studied in vivo to evaluate the ease and feasibility of implanting a new ultra-thin LV quadripolar microlead for cardiac resynchronization therapy (CRT).MethodsâandâResults:
Evaluable venograms were analyzed to define the prevalence of venous collaterals (>0.5 mm diameter) between (1) different LV segments; and (2) different major LV veins in unselected patients who underwent CRT from 2008 to 2012 at Rouen Hospital, France (retrospective); and CRT patients from the Axone Acute pilot study in 2018 (prospective). In prospective patients with evaluable venograms, LV microlead implantation was attempted. Thirty-six (21/65 retrospective, 15/20 prospective) patients had evaluable venograms with ≥1 visible venous collaterals. Collaterals were found between LV veins in all CRT patients with evaluable venograms. Regionally, prevalence was highest between the apical inferior and apical lateral (42%); and mid inferior and mid inferolateral (42%) segments. Collateral connections were most prevalent between the inferior interventricular vein (IIV) and lateral vein (64% [23/36]); and IIV and infero-lateral vein (36% [13/36]). Cross-vein microlead implantation was possible in 18 patients (90%), and single-vein implantation was conducted in the other 2 patients (10%).CONCLUSIONS:
Venous collaterals were found in vivo between LV veins in all CRT patients with evaluable venograms, making this network an option for accessing multiple LV sites using a single LV microlead.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Resynchronization Therapy
/
Heart Failure
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Circ J
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2021
Document type:
Article