Use of the Attain Select Ⅱ catheter delivery system to improve left ventricular lead implantation in cardiac resynchronization therapy

作     者：ZHOU Xian-hui TANG Bao-peng LI Jin-xin ZHANG Yu ZHANG Jiang-hua LI Yao-dong 

作者机构：Heart Center First Affiliated Hospital Xinjiang MedicalUniversity Urumqi Xinjiang 830000 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2011年第124卷第8期

页      面：1209-1212页

核心收录：

学科分类：0710[理学-生物学] 1002[医学-临床医学] 07[理学] 070201[理学-理论物理] 071003[理学-生理学] 0702[理学-物理学] 

主　　题：cardiac resynchronization therapy congestive heart failure the Attain Select Ⅱ catheter delivery system left ventricular lead implantation 

摘      要：Background Despite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy （CRT） devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac *** Totally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular （LV） lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select Ⅱ catheter delivery system. The patients were seen every 3-6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were *** There were no significant differences in the age, gender, New York Heart Association （NYHA） functional class,ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select Ⅱ catheter delivery system; LV lead implantation time from （51-7） minutes to （40±7） minutes （P 0.001）, procedure time from （143±17） minutes to （124±18）minutes （P=0.001）, and fluoroscopy time from （45±7） minutes to （35±6） minutes （P0.001）. A successful procedure of LV lead implantation was significantly improved from 17/23 （74%） patients using the standard techniques and equipment, to 20/21 （95.3%） patients using the Attain Select Ⅱ catheter delivery system （P=0.06）Conclusion It is feasible and safe to implant LV leads through the coronary sinus using the Attain Select Ⅱ catheter delivery system.