[1]陈少伯,姜铁民,梁国庆,等.心室同步化治疗保留左室电极导引钢丝技术的初步探讨[J].介入放射学杂志,2013,(02):99-101.
CHEN Shao? bo,JIANG Tie? min,LIANG Guo? qing,et al.Cardiac resynchronization therapy with retained left ventricular electrode guidewire: a preliminary investigation of the technology[J].journal interventional radiology,2013,(02):99-101.
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心室同步化治疗保留左室电极导引钢丝技术的初步探讨()
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
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- 期数:
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2013年02期
- 页码:
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99-101
- 栏目:
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心脏介入
- 出版日期:
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2013-02-25
文章信息/Info
- Title:
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Cardiac resynchronization therapy with retained left ventricular electrode guidewire: a preliminary investigation of the technology
- 作者:
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陈少伯; 姜铁民; 梁国庆; 赵季红; 赵 鹏; 李玉明
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- Author(s):
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CHEN Shao?蛳 bo; JIANG Tie?蛳 min; LIANG Guo?蛳 qing; ZHAO Ji?蛳 hong; ZHAO Peng; LI Yu?蛳 ming.
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Cardiology Center, Affiliated Hospital of Armed Police Logistics College, Tianjin 300162, China
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- 关键词:
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【关键词】 心力衰竭; 心室同步化治疗; 左室电极; 导引钢丝; 保留
- 文献标志码:
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A
- 摘要:
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【摘要】 目的 对比分析心室同步化治疗在保留左室电极导引钢丝前后的起搏参数,探讨该技术的有效性和可行性。方法 2009年6月—2012年6月收集左室电极植入困难患者8例,在保留左室电极导引钢丝前后分别测定起搏参数,包括起搏阈值、电极阻抗和膈肌刺激阈值,并在术后1、3、6和12个月进行门诊程控随访,在多普勒超声指引下进行参数优化。结果 保留钢丝前后的起搏阈值、电极阻抗和膈肌刺激阈值分别为(4.58 ± 1.57)V比(2.12 ± 1.35)V,(1 060 ± 182)Ω比(640 ± 213) Ω和(9.81 ± 2.05)V比(5.64 ± 2.97)V,保留钢丝明显降低起搏阈值、降低电极阻抗和膈肌刺激阈值,差异有统计学意义(P < 0.05)。术后12个月随访,所有患者心力衰竭症状改善,左室电极起搏参数与保留钢丝后即刻差异无统计学意义(P > 0.05),2例患者在体位变动时有膈肌刺激。结论 心室同步化治疗时,保留左室电极导引钢丝能有效改善起搏参数,安全可行。远期随访,膈肌刺激和钢丝断裂的问题有待观察。
参考文献/References:
[1] Schl?觟sser M, Stellbrink C. Indication for CRT[J]. Herzschritt?蛳 macherther Elektrophysiol, 2009, 20: 103 ?蛳 108.[2] 陈 康, 吴立群. 心脏再同步化治疗中左心室电极导线植入途径及位置[J]. 国际心血管病杂志, 2011, 38: 342 ?蛳 344.[3] Al?蛳 Khadra AS. Use of a modified introducer sheath with a side?蛳 hole to improve access to left ventricular veins with proximal origin[J]. Europace, 2006, 8: 56 ?蛳 59.[4] Papiashvili G, Anné W, Duytschaever M, et al. Just another case of lead dislocation?[J]. J Cardiovasc Electrophysiol, 2010, 21: 216 ?蛳 218.[5] De Cock CC, Jessurun ER, Allaart CA, et al. Repetitive intraoperative dislocation during transvenous left ventricular Lead implantation: usefulness of the retained guidewire technique[J]. Pacing Clin Electrophysiol, 2004, 27: 1589 ?蛳 1593.[6] Yi F, Shen M, Wu F, et al. Improving left ventricular pacing threshold using retained guidewire technique: a case report[J]. Europace, 2010, 12: 1792 ?蛳 1793.[7] Sankaranarayanan R, James MA. Use of a retained guidewire to improve the left ventricular pacing threshold[J]. Pacing Clin Electrophysiol, 2007, 30: 1285 ?蛳 1287.[8] Sherzer AI, Feigenblum DY, Pina JW, et al. Use of the retained guidewire technique facilitates left ventricular epicardial capture during biventricular defibrillator implantation[J]. Pacing Clin Electrophysiol, 2007, 30: 436 ?蛳 437.[9] de Cock CC, Res JC, Hendriks ML, et al. Usefulness of a pacing guidewire to facilitate left ventricular lead implantation in cardiac resynchronization therapy[J]. Pacing Clin Electrophysiol, 2009, 32: 446 ?蛳 449.[10] N?覿gele H, Hashagen S, Ergin M, et al. Coronary sinus lead fragmentation 2 years after implantation with a retained guidewire[J]. Pacing Clin Electrophysiol, 2007, 30: 438 ?蛳 439.[11] Arbelo E, García ?蛳 Quintana A, Caballero E, et al. Late failure of left ventricular leads stabilized using the retained guidewire technique in patients undergoing cardiac resynchronization therapy[J]. Rev Esp Cardiol, 2008, 61: 91 ?蛳 94.
备注/Memo
- 备注/Memo:
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(收稿日期:2012-08-16)
更新日期/Last Update: