Early human experience with use of a deflectable fiberoptic endocardial visualization catheter to facilitate coronary sinus cannulation

被引:16
作者
Anh, D. J.
Chen, Henry A.
Eversull, Christian S.
Mourlas, Nicholas J.
Mead, R. Hardwin
Liem, L. Bing
Hsia, Henry H.
Wang, Pau J.
Al-Ahmad, Amin
机构
[1] Stanford Univ, Med Ctr, Cardiac Arrythmia Serv, Stanford, CA 94305 USA
[2] Acumen Med Inc, Sunnyvale, CA USA
[3] Sequoia Hosp, Redwood City, CA USA
[4] New Mexico Heart Inst, Albuquerque, NM USA
关键词
cardiac resynchronization therapy; coronary sinus;
D O I
10.1016/j.hrthm.2006.04.029
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Despite improvements in cardiac resynchronization therapy (CRT) implantation techniques, a significant minority of CRT attempts are unsuccessful. Inability to cannulate the coronary sinus (CS) because of difficult anatomy is a major reason for unsuccessful CRT implantation. Direct visualization of intracardiac structures during the implant may facilitate access into the CS. The present study describes CRT implantation with the aid of an endocardial visualization catheter (EVC). METHODS Fifty-eight consecutive patients (mean age 72 +/- 12 years; ejection fraction 26.2% +/- 7.0%; New York Heart Association [NYHA] class 2.9) underwent CRT implantation using a steerable fiberoptic EVC (Acumen Medical, Inc., Sunnyvale, CA). RESULTS The EVC was able to visualize the CS ostium in all cases. The CS was successfully cannulated in 57 (98.3%) of 58 patients. The time from vascular access to CS visualization was 6 +/- 5 minutes, and the total time to CS access was 8 +/- 6 minutes. Successful left ventricle (LV) lead implantation was accomplished in 55 (94.8%) of 58 patients. Three patients who had a previous history of failed LV Lead implantation were successfully implanted using the EVC. CONCLUSION Fiberoptic imaging of intracardiac structures during CRT implantation may be performed rapidly in a wide range of patients with an EVC. The ability to visualize right atrial anatomy may aid CS access and LV Lead implantation.
引用
收藏
页码:875 / 878
页数:4
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