Journal Article

12. Cardiac Resynchronization Therapy: Surgical Approach

G. Pistis, C. Comoglio, F. Parisi, S. Grossi, G. Bardi, E. Caruzzo, G. Punta, R. Riccardi, R. Casabona, P. Silvestri and R. Bevilacqua

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S19-S20
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.163
12. Cardiac Resynchronization Therapy: Surgical Approach

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Background

It's currently estimated that 15% of attempted transvenous left heart lead placements fail due to anatomical anomalies. Alternatively, epicardial leads can be used to deliver pacing, with some advantages over transvenous leads: freedom to select the best pacing site, a lower incidence of reinterventions, more control over the implant duration and x-ray exposure.

Methods used

an epicardial implant of Myodex (Model 1084T, St. Jude Medical Inc.) was performed on a patient suffering for worsening of heart failure. A first attempt through transvenous approach failed due to the inability to cannulate the coronary sinus. The epicardial lead was successfully positioned in a postero-lateral position through the 4th intercostal space thanks to the active fixation.

Results

Thanks to the steroid elution, electrical measurements were good (sensing 4,4 mV, threshold 1,3V@0,5ms, impedance 508 Ohm) in 1 hour implant time. After 3 days the pacing threshold was 0,75V@0,5 ms.

Conclusions

According to this first experience it's possible to underline the advantages of this new epicardial lead in terms of implant feasibility and good pacing measurements compared to the traditional active leads without steroid elution.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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