Single- and dual-site ventricular pacing entirely through the coronary sinus for patients with prior tricuspid valve surgery
| Autor: | Chin C. Lee, Philip M. Chang, Sati Patel, Steven K. Carlson, Tomas Konecny, Khuyen Do, Rahul N. Doshi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Cardiac resynchronization therapy 030204 cardiovascular system & hematology Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Physiology (medical) medicine Humans 030212 general & internal medicine Thoracotomy Contraindication Coronary sinus Retrospective Studies Tricuspid valve Ejection fraction business.industry Cardiac Pacing Artificial Coronary Sinus Stroke Volume Middle Aged Tricuspid Valve Insufficiency Surgery Transvenous pacing medicine.anatomical_structure Female Implant Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 56(1) |
| ISSN: | 1572-8595 |
| Popis: | Transvenous right ventricular pacing has traditionally been avoided after surgical tricuspid valve repair or replacement because of possible valvular dysfunction. Epicardial pacing has been used but it requires surgical thoracotomy and has higher lead failure rates when compared to transvenous pacing. We evaluated the lead stability and clinical outcomes in patients with isolated coronary sinus (CS) lead due to relative contraindication to transvenous pacing from prior tricuspid valve (TV) surgery. We retrospectively examined a single-center cohort of 34 patients with TV disease and/or surgery who underwent permanent pacemaker implantation with a left ventricular CS lead as the only ventricular pacing lead (to avoid crossing the TV). The clinical outcome, echocardiographic data, and pacing thresholds were evaluated at follow-up. We implanted 19 patients with a single-CS lead and 15 patients with dual-CS leads. The average left ventricular ejection fraction was 56 ± 13% prior to lead implantation and remained stable at 2-year follow-up. The tricuspid regurgitation remained mild at follow-up. The average lead pacing threshold was 1.2 ± 0.6 V × ms at implant and 1.1 ± 0.4 V × ms at 2-year follow-up (P = 0.39). For patients with dual-CS leads, the pacing threshold was 1.2 ± 0.7 V × ms at implant and 1.1 ± 0.5 V × ms at 2-year follow-up (P = 0.52). The use of ventricular pacing entirely through the CS is an effective and minimally invasive method that provides stable pacing for patients with prior TV surgery in whom transvenous lead placement either is not possible or is relatively contraindicated. |
| Databáze: | OpenAIRE |
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