PMID- 11559679
OWN - NLM
STAT- MEDLINE
DCOM- 20011011
LR  - 20220311
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 86
IP  - 4
DP  - 2001 Oct
TI  - Six year experience of transvenous left ventricular lead implantation for 
      permanent biventricular pacing in patients with advanced heart failure: technical 
      aspects.
PG  - 405-10
AB  - BACKGROUND: Biventricular pacing has been proposed as an adjuvant to optimal 
      medical treatment in patients with drug refractory heart failure caused by 
      chronic left ventricular systolic dysfunction and intraventricular conduction 
      delay. OBJECTIVE: To assess the technical feasibility and long term results (over 
      six years) of transverse left ventricular pacing with the lead inserted into a 
      tributary vein of the coronary sinus. SUBJECTS: From August 1994 to February 
      2000, left ventricular lead implantation was attempted in 116 patients who were 
      eligible for biventricular pacing (mean (SD) age 67 (9) years, New York Heart 
      Association (NYHA) functional class III/IV, left ventricular ejection fraction 22 
      (6)%, QRS duration 185 (26) ms). RESULTS: The overall implantation success rate 
      was 88% (n = 102). A learning curve was indicated by a progressive increase in 
      success from 61% early on to 98% in the last year. The mean pacing threshold was 
      1.1 (0.7) V/0.5 ms at the time of implantation and increased slightly up to 1.9 
      (0.9) V/0.5 ms at the end of the follow up period (15 (13) months). The rate of 
      acute and delayed left ventricular lead dislodgement decreased from 30% in the 
      early years to 11% after 1999. During follow up, 19 patients required reoperation 
      for delayed lead dislodgement or increase in left ventricular pacing threshold (n 
      = 15), phrenic nerve stimulation (n = 3), or infection (n = 3). CONCLUSIONS: 
      Transverse left ventricular pacing through the coronary sinus is feasible and 
      safe. The rate of implantation failure and of lead related problems has decreased 
      greatly with increasing experience and with improvements in the equipment.
FAU - Alonso, C
AU  - Alonso C
AD  - Departement de Cardiologie et Maladies Cardio-vasculaires, Centre 
      Cardio-Pneumologique, Hopital Pontchaillou, 2 rue Henri Le Guilloux, 35033 
      Rennes, France.
FAU - Leclercq, C
AU  - Leclercq C
FAU - d'Allonnes, F R
AU  - d'Allonnes FR
FAU - Pavin, D
AU  - Pavin D
FAU - Victor, F
AU  - Victor F
FAU - Mabo, P
AU  - Mabo P
FAU - Daubert, J C
AU  - Daubert JC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Aged
MH  - Cardiac Output, Low/physiopathology/*therapy
MH  - Cardiac Pacing, Artificial/*methods
MH  - *Defibrillators, Implantable
MH  - Feasibility Studies
MH  - Follow-Up Studies
MH  - Humans
MH  - Intraoperative Care/methods
MH  - Reoperation
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/therapy
PMC - PMC1729936
EDAT- 2001/09/18 10:00
MHDA- 2001/10/12 10:01
PMCR- 2004/10/01
CRDT- 2001/09/18 10:00
PHST- 2001/09/18 10:00 [pubmed]
PHST- 2001/10/12 10:01 [medline]
PHST- 2001/09/18 10:00 [entrez]
PHST- 2004/10/01 00:00 [pmc-release]
AID - 10.1136/heart.86.4.405 [doi]
PST - ppublish
SO  - Heart. 2001 Oct;86(4):405-10. doi: 10.1136/heart.86.4.405.