Coronary sinus side branches for cardiac resynchronization therapy

Prospective evaluation of availability, implant success, and procedural determinants

G. Duray, Stefan H. Hohnloser, Carsten W. Israel

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Coronary Sinus Side Branches for Cardiac Resynchronization Therapy. Introduction: There are only sparse data concerning individual coronary side branch (CS-SB) anatomy with respect to LV lead implantation for cardiac resynchronization therapy (CRT). Methods: In patients (pts) undergoing CRT device implantation, a detailed venogram was obtained, and the CS-SB of first, second, third, and fourth choices for CS-lead implantation was defined. Study endpoints included successful LV lead implantation in the first choice CS-SB, number of CS-SB potentially available, implantation success in selected CS-SB, procedural variables, and 6-month response to CRT. Results: CRT defibrillator implantation was attempted in 77 pts. Only 1 suitable CS-SB was present in 3 (4%), 2 in 20 (26%), 3 in 36 (47%), and 4 CS-SB in 18 patients (23%). The LV lead was implanted in the first choice CS-SB in 71% of patients, in the second choice in 16%, in the third choice in 3%. In 4 patients (5%) no LV lead could be implanted. Implant success was similar for different CS-SB regions (P = ns). Successful LV lead implantation in the CS-SB of first choice was associated with median fluoroscopy and procedure times of 20 ± 13 and 143 ± 41 minutes. Corresponding times for the CS-SB of ≥ second choice were 38 ± 21 (P = 0.002) and 179 ± 47 minutes (P = 0.002). Response rate at 6 months was 64% for patients with LV leads in the first target CS-SB. Conclusions: In 70% of patients undergoing CRT device implantation, at least three suitable CS-SBs are available. Implant success in the CS-SB of first choice is 71% without significant differences for any particular CS-SB region.

Original languageEnglish
Pages (from-to)489-494
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume19
Issue number5
DOIs
Publication statusPublished - May 2008

Fingerprint

Cardiac Resynchronization Therapy
Coronary Sinus
Cardiac Resynchronization Therapy Devices
Defibrillators
Fluoroscopy
Anatomy
Lead

Keywords

  • Biventricular pacing
  • Cardiac resynchronization therapy
  • Coronary sinus anatomy
  • Implantation
  • Response

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Coronary sinus side branches for cardiac resynchronization therapy : Prospective evaluation of availability, implant success, and procedural determinants. / Duray, G.; Hohnloser, Stefan H.; Israel, Carsten W.

In: Journal of Cardiovascular Electrophysiology, Vol. 19, No. 5, 05.2008, p. 489-494.

Research output: Contribution to journalArticle

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abstract = "Coronary Sinus Side Branches for Cardiac Resynchronization Therapy. Introduction: There are only sparse data concerning individual coronary side branch (CS-SB) anatomy with respect to LV lead implantation for cardiac resynchronization therapy (CRT). Methods: In patients (pts) undergoing CRT device implantation, a detailed venogram was obtained, and the CS-SB of first, second, third, and fourth choices for CS-lead implantation was defined. Study endpoints included successful LV lead implantation in the first choice CS-SB, number of CS-SB potentially available, implantation success in selected CS-SB, procedural variables, and 6-month response to CRT. Results: CRT defibrillator implantation was attempted in 77 pts. Only 1 suitable CS-SB was present in 3 (4{\%}), 2 in 20 (26{\%}), 3 in 36 (47{\%}), and 4 CS-SB in 18 patients (23{\%}). The LV lead was implanted in the first choice CS-SB in 71{\%} of patients, in the second choice in 16{\%}, in the third choice in 3{\%}. In 4 patients (5{\%}) no LV lead could be implanted. Implant success was similar for different CS-SB regions (P = ns). Successful LV lead implantation in the CS-SB of first choice was associated with median fluoroscopy and procedure times of 20 ± 13 and 143 ± 41 minutes. Corresponding times for the CS-SB of ≥ second choice were 38 ± 21 (P = 0.002) and 179 ± 47 minutes (P = 0.002). Response rate at 6 months was 64{\%} for patients with LV leads in the first target CS-SB. Conclusions: In 70{\%} of patients undergoing CRT device implantation, at least three suitable CS-SBs are available. Implant success in the CS-SB of first choice is 71{\%} without significant differences for any particular CS-SB region.",
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