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Ghossein MA, Zanon F, Salden F, van Stipdonk A, Marcantoni L, Engels E, Luermans J, Westra S, Prinzen F, Vernooy K. Left Ventricular Lead Placement Guided by Reduction in QRS Area. J Clin Med 2021; 10:jcm10245935. [PMID: 34945236 PMCID: PMC8707800 DOI: 10.3390/jcm10245935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/07/2022] Open
Abstract
Background: Reduction in QRS area after cardiac resynchronization therapy (CRT) is associated with improved long-term clinical outcome. The aim of this study was to investigate whether the reduction in QRS area is associated with hemodynamic improvement by pacing different LV sites and can be used to guide LV lead placement. Methods: Patients with a class Ia/IIa CRT indication were prospectively included from three hospitals. Acute hemodynamic response was assessed as the relative change in maximum rate of rise of left ventricular (LV) pressure (%∆LVdP/dtmax). Change in QRS area (∆QRS area), in QRS duration (∆QRS duration), and %∆LVdP/dtmax were studied in relation to different LV pacing locations within a patient. Results: Data from 52 patients paced at 188 different LV pacing sites were investigated. Lateral LV pacing resulted in a larger %∆LVdP/dtmax than anterior or posterior pacing (p = 0.0007). A similar trend was found for ∆QRS area (p = 0.001) but not for ∆QRS duration (p = 0.23). Pacing from the proximal electrode pair resulted in a larger %∆LVdP/dtmax (p = 0.004), and ∆QRS area (p = 0.003) but not ∆QRS duration (p = 0.77). Within patients, correlation between ∆QRS area and %∆LVdP/dtmax was 0.76 (median, IQR 0.35; 0,89). Conclusion: Within patients, ∆QRS area is associated with %∆LVdP/dtmax at different LV pacing locations. Therefore, QRS area, which is an easily, noninvasively obtainable and objective parameter, may be useful to guide LV lead placement in CRT.
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Affiliation(s)
- Mohammed Ali Ghossein
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands;
- Correspondence:
| | - Francesco Zanon
- Santa Maria Della Misericordia General Hospital, 45100 Rovigo, Italy; (F.Z.); (L.M.)
| | - Floor Salden
- Maastricht University Medical Center, Department of Cardiology, Maastricht University, 6229 HX Maastricht, The Netherlands; (F.S.); (A.v.S.); (J.L.); (K.V.)
| | - Antonius van Stipdonk
- Maastricht University Medical Center, Department of Cardiology, Maastricht University, 6229 HX Maastricht, The Netherlands; (F.S.); (A.v.S.); (J.L.); (K.V.)
| | - Lina Marcantoni
- Santa Maria Della Misericordia General Hospital, 45100 Rovigo, Italy; (F.Z.); (L.M.)
| | - Elien Engels
- Yale New Haven Hospital, New Haven, CT 06510, USA;
| | - Justin Luermans
- Maastricht University Medical Center, Department of Cardiology, Maastricht University, 6229 HX Maastricht, The Netherlands; (F.S.); (A.v.S.); (J.L.); (K.V.)
| | - Sjoerd Westra
- Radboud University Medical Center, Radboud University Nijmegen, 6525 GA Nijmegen, The Netherlands;
| | - Frits Prinzen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Kevin Vernooy
- Maastricht University Medical Center, Department of Cardiology, Maastricht University, 6229 HX Maastricht, The Netherlands; (F.S.); (A.v.S.); (J.L.); (K.V.)
- Radboud University Medical Center, Radboud University Nijmegen, 6525 GA Nijmegen, The Netherlands;
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2
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Shaik NA, Drucker M, Pierce C, Duray GZ, Gillett S, Miller C, Harrell C, Thomas G. Novel two-lead cardiac resynchronization therapy system provides equivalent CRT responses with less complications than a conventional three-lead system: Results from the QP ExCELs lead registry. J Cardiovasc Electrophysiol 2020; 31:1784-1792. [PMID: 32412126 PMCID: PMC7496977 DOI: 10.1111/jce.14552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 01/20/2023]
Abstract
Introduction The novel two‐lead cardiac resynchronization therapy (CRT)‐DX system utilizes a floating atrial dipole on the implantable cardioverter‐defibrillator lead, and when implanted with a left ventricular (LV) lead, offers a two‐lead CRT system with AV synchrony. This study compared complication rates and CRT response among subjects implanted with a two‐lead CRT‐DX system to those subjects implanted with a standard three‐lead CRT‐D system. Methods and Results A total of 240 subjects from the Sentus QP—Extended CRT Evaluation with Quadripolar Left Ventricular Leads postapproval study were selected to identify 120 matched pairs based on similar demographic characteristics using a Greedy algorithm. The complication‐free rate was evaluated as the primary endpoint. All‐cause mortality, heart failure hospitalizations, device diagnostic data, New York Heart Association (NYHA) class improvement, and defibrillator therapy were evaluated from clinical data, in‐office interrogations, and remote monitoring throughout the follow‐up period. Complication‐free survival favored the CRT‐DX group with 92.5% without a major complication compared to 85.0% in the CRT‐D cohort (P = .0495; 95% confidence interval: 0.1%‐14.9%) over a mean follow‐up of 1.3 and 1.4 years, respectively. Incidence of all‐cause mortality, heart failure hospitalizations, NYHA changes at 6 months postimplant, and percent of LV pacing during CRT therapy were similar in both device cohorts. Inappropriate shocks were more frequent in the CRT‐D cohort with 5.8% of subjects receiving an inappropriate shock vs 0.8% in the CRT‐DX cohort. Conclusion The results of this subanalysis demonstrate that the CRT‐DX system can provide similar CRT responses and significantly fewer complications when compared to a similar cohort with a conventional three‐lead CRT‐D system.
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Affiliation(s)
- Naushad A Shaik
- Department of Cardiac Electrophysiology, Advent Health Orlando, Orlando, Florida
| | - Michael Drucker
- Department of Cardiac Electrophysiology, Novant Health Cardiology of Forsyth Medical Center, Winston-Salem, North Carolina
| | - Christopher Pierce
- Department of Cardiac Electrophysiology, Sanford Medical Center, Fargo, North Dakota
| | - Gabor Z Duray
- Department of Cardiology, Medical Centre, Hungarian Defense Forces, Budapest, Hungary
| | - Shane Gillett
- Clinical Studies Department, Biotronik, Inc, Lake Oswego, Oregon
| | - Crystal Miller
- Clinical Studies Department, Biotronik, Inc, Lake Oswego, Oregon
| | - Camden Harrell
- Clinical Studies Department, Biotronik, Inc, Lake Oswego, Oregon
| | - George Thomas
- Division of Cardiology, Weill Cornell Medical College, New York, New York
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3
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Zanon F, Marcantoni L, Baracca E, Pastore G, Giau G, Rigatelli G, Lanza D, Picariello C, Aggio S, Giatti S, Zuin M, Roncon L, Pacetta D, Noventa F, Prinzen FW. Hemodynamic comparison of different multisites and multipoint pacing strategies in cardiac resynchronization therapies. J Interv Card Electrophysiol 2018; 53:31-39. [PMID: 29627954 PMCID: PMC6153901 DOI: 10.1007/s10840-018-0362-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/22/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE In order to increase the responder rate to CRT, stimulation of the left ventricular (LV) from multiple sites has been suggested as a promising alternative to standard biventricular pacing (BIV). The aim of the study was to compare, in a group of candidates for CRT, the effects of different pacing configurations-BIV, triple ventricular (TRIV) by means of two LV leads, multipoint (MPP), and multipoint plus a second LV lead (MPP + TRIV) pacing-on both hemodynamics and QRS duration. METHODS Fifteen patients (13 male) with permanent AF (mean age 76 ± 7 years; left ventricular ejection fraction 33 ± 7%; 7 with ischemic cardiomyopathy; mean QRS duration 178 ± 25 ms) were selected as candidates for CRT. Two LV leads were positioned in two different branches of the coronary sinus. Acute hemodynamic response was evaluated by means of a RADI pressure wire as the variation in LVdp/dtmax. RESULTS Per patient, 2.7 ± 0.7 veins and 5.2 ± 1.9 pacing sites were evaluated. From baseline values of 998 ± 186 mmHg/s, BIV, TRIV, MPP, and MPP-TRIV pacing increased LVdp/dtmax to 1200 ± 281 mmHg/s, 1226 ± 284 mmHg/s, 1274 ± 303 mmHg, and 1289 ± 298 mmHg, respectively (p < 0.001). Bonferroni post-hoc analysis showed significantly higher values during all pacing configurations in comparison with the baseline; moreover, higher values were recorded during MPP and MPP + TRIV than at the baseline or during BIV and also during MPP + TRIV than during TRIV. Mean QRS width decreased from 178 ± 25 ms at the baseline to 171 ± 21, 167 ± 20, 168 ± 20, and 164 ± 15 ms, during BIV, TRIV, MPP, and MPP-TRIV, respectively (p < 0.001). CONCLUSIONS In patients with AF, the acute response to CRT improves as the size of the early activated LV region increases.
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Affiliation(s)
- Francesco Zanon
- Arrhythmia and Electrophysiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy. .,Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy.
| | - Lina Marcantoni
- Arrhythmia and Electrophysiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy.,Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Enrico Baracca
- Arrhythmia and Electrophysiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy.,Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Gianni Pastore
- Arrhythmia and Electrophysiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy.,Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Giuseppina Giau
- Arrhythmia and Electrophysiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy.,Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Gianluca Rigatelli
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy.,Interventional Cardiology Unit, Santa Maria Della Misericordia General Hospital, Rovigo, Italy
| | - Daniela Lanza
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Claudio Picariello
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Silvio Aggio
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Sara Giatti
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Marco Zuin
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | - Loris Roncon
- Cardiology Department, Santa Maria Della Misericordia General Hospital, 140, Viale Tre Martiri, 45100, Rovigo, Italy
| | | | - Franco Noventa
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Frits W Prinzen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
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4
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Manolis AS, Koulouris S, Tsiachris D. Electrophysiology Catheter-Facilitated coronary sinus cannulation and implantation of cardiac resynchronization therapy systems. Hellenic J Cardiol 2017; 59:26-33. [PMID: 28778735 DOI: 10.1016/j.hjc.2017.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cardiac resynchronization therapy (CRT) device implantation is hampered by difficult placement of the left ventricular (LV) lead. We have routinely used a steerable electrophysiology catheter to guide coronary sinus (CS) cannulation and facilitate LV lead positioning. The aim of this prospective study is to present our results with this approach in 138 consecutive patients receiving a CRT device over 10 years. METHODS The study included 120 men and 18 women, aged 64.8±11.4 years, with coronary disease (n=63), cardiomyopathy (n=72), or other disease (n=3), and mean ejection fraction of 24.5±4.5%. Devices were implanted for refractory heart failure and dyssynchrony, all but 2 in the presence of left bundle branch block. Implanted devices included biventricular pacemakers (CRT-P) (n=33) and cardioverter defibrillators (CRT-D) (n=105). RESULTS Using the electrophysiology catheter, the CS could be engaged in 134 (97.1%) patients. In 4 patients failing CS cannulation, a dual-chamber device was implanted in 2, and bifocal right ventricular pacing was effected in 2. Bifocal (n=2) or conventional (n=1) systems were implanted in another 3 patients, in whom the LV lead got dislodged (n=2) or removed because of local dissection (n=1). Thus, finally, a CRT system was successfully established in 131 (94.9%) patients. There were 3 patients with CS dissection, of whom 1 was complicated by cardiac tamponade managed with pericardiocentesis. There were no perioperative deaths. During follow-up (31.0±21.2 months), clinical improvement was reported by 108 (82.4%) patients. CONCLUSION Routine use of an electrophysiology catheter greatly facilitated CS cannulation and successful LV lead placement in ∼95% of patients undergoing CRT system implantation.
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Affiliation(s)
- Antonis S Manolis
- Third Department of Cardiology, Athens University School of Medicine, Athens, Greece.
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5
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MITTAL SUNEET, NAIR DEVI, PADANILAM BENZYJ, CIUFFO ALLEN, GUPTA NIGEL, GALLAGHER PETER, GOLDNER BRUCE, HAMMILL ERICF, WOLD NICOLAS, STEIN KENNETH, BURKE MARTIN. Performance of Anatomically Designed Quadripolar Left Ventricular Leads: Results from the NAVIGATE X4 Clinical Trial. J Cardiovasc Electrophysiol 2016; 27:1199-1205. [DOI: 10.1111/jce.13044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 06/24/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | - DEVI NAIR
- Division of Cardiac Electrophysiology, Department of Medicine St. Bernard's Heart & Vascular Center Jonesboro AR USA
| | | | - ALLEN CIUFFO
- Department of Medicine Sentara Heart Hospital Norfolk VA USA
| | - NIGEL GUPTA
- Department of Medicine, Kaiser Permanente Los Angeles Medical Center Los Angeles CA USA
| | - PETER GALLAGHER
- Department of Medicine Nebraska Heart Institute Lincoln NE USA
| | - BRUCE GOLDNER
- Department of Medicine Northwell Health System New Hyde Park NY USA
| | | | | | | | - MARTIN BURKE
- Section of Cardiology, Department of Medicine, Heart Rhythm Center University of Chicago USA
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6
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Zanon F, Marcantoni L, Baracca E, Pastore G, Lanza D, Fraccaro C, Picariello C, Conte L, Aggio S, Roncon L, Pacetta D, Badie N, Noventa F, Prinzen FW. Optimization of left ventricular pacing site plus multipoint pacing improves remodeling and clinical response to cardiac resynchronization therapy at 1 year. Heart Rhythm 2016; 13:1644-51. [DOI: 10.1016/j.hrthm.2016.05.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Indexed: 11/29/2022]
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7
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Multipoint pacing by a left ventricular quadripolar lead improves the acute hemodynamic response to CRT compared with conventional biventricular pacing at any site. Heart Rhythm 2015; 12:975-81. [DOI: 10.1016/j.hrthm.2015.01.034] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Indexed: 11/20/2022]
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8
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Zanon F, Baracca E, Pastore G, Fraccaro C, Roncon L, Aggio S, Noventa F, Mazza A, Prinzen F. Determination of the longest intrapatient left ventricular electrical delay may predict acute hemodynamic improvement in patients after cardiac resynchronization therapy. Circ Arrhythm Electrophysiol 2014; 7:377-83. [PMID: 24668162 DOI: 10.1161/circep.113.000850] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND One of the reasons for patient nonresponse to cardiac resynchronization therapy is a suboptimal left ventricular (LV) pacing site. LV electric delay (Q-LV interval) has been indicated as a prognostic parameter of cardiac resynchronization therapy response. This study evaluates the LV delay for the optimization of the LV pacing site. METHODS AND RESULTS Thirty-two consecutive patients (23 men; mean age, 71±11 years; LV ejection fraction, 30±6%; 18 with ischemic cardiomyopathy; QRS, 181±25 ms; all mean±SD) underwent cardiac resynchronization therapy device implantation. All available tributary veins of the coronary sinus were tested, and the Q-LV interval was measured at each pacing site. The hemodynamic effects of pacing at different sites were evaluated by invasive measurement of LV dP/dtmax at baseline and during pacing. Overall, 2.9±0.8 different veins and 6.4±2.3 pacing sites were tested. In 31 of 32 (96.8%) patients, the highest LV dP/dtmax coincided with the maximum Q-LV interval. Q-LV interval correlated with the increase in LV dP/dtmax in all patients at each site (AR1 ρ=0.98; P<0.001). A Q-LV value >95 ms corresponded to a >10% in LV dP/dtmax. An inverse correlation between paced QRS duration and improvement in LV dP/dtmax was seen in 24 patients (75%). CONCLUSIONS Pacing the LV at the latest activated site is highly predictive of the maximum increase in contractility, expressed as LV dP/dtmax. A positive correlation between Q-LV interval and hemodynamic improvement was found in all patients at every pacing site, a value of 95 ms corresponding to an increase in LV dP/dtmax of ≥10%.
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Affiliation(s)
- Francesco Zanon
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.).
| | - Enrico Baracca
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Gianni Pastore
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Chiara Fraccaro
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Loris Roncon
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Silvio Aggio
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Franco Noventa
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Alberto Mazza
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
| | - Frits Prinzen
- From the Arrhythmia and Electrophysiology Unit (F.Z., E.B., G.P.), Division of Cardiology (C.F., L.R., S.A.), and Department of Internal Medicine (A.M.), Santa Maria Della Misericordia Hospital, Rovigo, Italy; Department of Molecular Medicine, of Padua, Padua, Italy (F.N.); and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (F.P.)
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García-Bolao I, Calvo N, Gavira JJ, Moreno-Galdós L, Arguedas-Jiménez H, Canepa JP, García-De-Yébenes M. [Current status of cardiac resynchronization therapy]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2012; 82:235-42. [PMID: 23021361 DOI: 10.1016/j.acmx.2012.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 02/27/2012] [Accepted: 04/02/2012] [Indexed: 10/27/2022] Open
Abstract
The present document reviews various aspects of the current status of cardiac resynchronization therapy: mechanisms of action, current indications and implantation technique.
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Affiliation(s)
- Ignacio García-Bolao
- Unidad de Electrofisiología y Arritmias, Departamento de Cardiología y Cirugía Cardiaca, Clínica Universidad de Navarra, Pamplona, España.
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10
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Minden HH. [Technical innovations and limitation in cardiac electrotherapy]. Herzschrittmacherther Elektrophysiol 2011; 22:11-5. [PMID: 21344233 DOI: 10.1007/s00399-011-0117-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coronary sinus (CS) lead positioning is one of the main determinants of cardiac resynchronization therapy (CRT). The implantation of the CS lead is faced with several technical difficulties that may prevent the achievement of a stable position and good performance of the CS lead without phrenic nerve stimulation (PNS). New developments in catheter and lead technology to overcome these difficulties are presented.
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Affiliation(s)
- H-H Minden
- Klinik für Innere Medizin/Kardiologie, Oberhavel-Kliniken, Marwitzer Str. 91, 16761, Hennigsdorf, Deutschland.
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11
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Dilaveris P, Sideris S, Vaina S, Gatzoulis K, Stefanadis C. Achievement of Right Ventricular Pacing by Use of a Long Guiding Catheter in a Hemodialysis Patient Presenting Significant Tortuosity of Vasculature. Cardiol Res Pract 2011; 2011:372026. [PMID: 21559265 PMCID: PMC3087942 DOI: 10.4061/2011/372026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 02/24/2011] [Indexed: 12/02/2022] Open
Abstract
Increased vascular calcification and tortuosity are rather common in end-stage renal failure patients who are on hemodialysis. It renders manipulation of catheters and performance of percutaneous transluminal interventions more difficult than expected. Such vascular alterations may be evident in large veins and pose significant difficulties in placement of pacing leads as shown in our case. To overcome such difficulties, we demonstrated in this patient case that long guiding catheters may be of particular value.
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Affiliation(s)
- Polychronis Dilaveris
- 1st University Department of Cardiology, Hippokration Hospital, 155 61 Athens, Greece
| | - Skevos Sideris
- 1st University Department of Cardiology, Hippokration Hospital, 155 61 Athens, Greece
| | - Sofia Vaina
- 1st University Department of Cardiology, Hippokration Hospital, 155 61 Athens, Greece
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12
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VOIGT ANDREW, SHALABY ALAA, SABA SAMIR. Continued Rise in Rates of Cardiovascular Implantable Electronic Device Infections in the United States: Temporal Trends and Causative Insights. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 33:414-9. [DOI: 10.1111/j.1540-8159.2009.02569.x] [Citation(s) in RCA: 303] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Knackstedt C, Schimpf T, Napp A, Wessling B, Rothe C, Mischke K, Schnakenberg U, Schauerte P. Super-selective electrical stimulation of the left ventricle via a miniaturized magnetized stimulation wire: proof of concept study. BIOMED ENG-BIOMED TE 2010; 55:285-90. [DOI: 10.1515/bmt.2010.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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LAU ERNESTW. Achieving Permanent Left Ventricular Pacing-Options and Choice. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2009; 32:1466-77. [DOI: 10.1111/j.1540-8159.2009.02514.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lau EW. A streamlined technique of trans-septal endocardial left ventricular lead placement. J Interv Card Electrophysiol 2009; 26:73-81. [DOI: 10.1007/s10840-009-9395-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 03/02/2009] [Indexed: 10/20/2022]
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