Mapping the coronary sinus and great cardiac vein

被引:16
作者
Giudici, M
Winston, S
Kappler, J
Shinn, T
Singer, I
Scheiner, A
Berrier, H
Herner, M
Sample, R
机构
[1] Guidant Corp, Dept Therapy Res, St Paul, MN 55112 USA
[2] Genesis Med Ctr, Davenport, IA USA
[3] St Joseph Mercy, Ann Arbor, MI USA
[4] Univ Louisville, Louisville, KY 40292 USA
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2002年 / 25卷 / 04期
关键词
pacing; sensing; atrial pacing; coronary sinus; great cardiac vein;
D O I
10.1046/j.1460-9592.2002.00414.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The purpose of this study was to develop a better understanding of the pacing and sensing characteristics of electrodes placed in the proximal cardiac veins.,A detailed mapping of the coronary sinus (CS) and great cardiac vein (GCV) was done on 25 patients with normal sinus rhythm using a deflectable electrophysiological catheter. Intrinsic bipolar electrograms and atrial and ventricular pacing voltage thresholds were measured. For measurement purposes, the GGV and the CS were each subdivided into distal (D), middle (M), and proximal (P) regions, for a total of six test locations, Within the CS and GCV, the average atrial pacing threshold was always lower (P < 0.05) than the ventricle with an average ventricular to atrial ratio > 5, except for the GCV-D. The average atrial threshold in the CS and GCV ranged from 0.2- to 1.0-V higher than in the atrial appendage. Diaphragmatic pacing was observed in three patients. Atrial signal amplitude was greatest in the CS-M, CS-D, and GCV-P and smaller in the CS-P, GGV-M, and GCV-D. Electrode spacing did not significantly affect P wave amplitude, while narrower electrode spacing attenuated R wave amplitude. The average P:R ratio was highest with 5-mm-spaced electrodes compared to wider spaced pairs. The P:R ratio in the CS was higher (P < 0.05) than in all positions of the GVC. It is possible to pace the atrium independent of the ventricle at reasonably low thresholds and to detect atrialdepolarization without undue cross-talk or noise using closely spaced bipolar electrode pairs. The areas of the proximal, middle, and distal CS produced the best combination of pacing and sensing parameters.
引用
收藏
页码:414 / 419
页数:6
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