克服左束支区起搏中的导联穿透失败

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2024-09-09 DOI:10.1016/j.jacep.2024.07.021

Aymeric Menet, Inès Belkahia, Outteryck François, Guillaume Toubeau, Noémie Selin, Jeremy Layec, Marie Decroocq, Yves Guyomar, Sylvestre Maréchaux, Guillaume Viart

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引用次数: 0

摘要

左束支区起搏是一种用于保持左心室同步性的创新技术。然而，操作员在拧螺丝时将导联穿入室间隔可能面临挑战。两个陷阱--仅螺旋穿透和浅穿透--阻碍了导联穿透。这项研究分两个阶段在病人和猪的心脏上进行，测试了克服这些问题的两种技术。研究结果强调了心内膜参与的影响，并建议最佳技术是有意制造心内膜破口，而不是简单地拧下再拧上。这种解决方案可以最大限度地减少到达起搏部位的尝试次数，从而降低并发症的风险，为手术提供便利。

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Overcoming Lead Penetration Failure in Left Bundle Branch Area Pacing.

Left bundle branch area pacing is an innovative technique employed to maintain left ventricular synchrony. However, the operator can face challenges in penetrating the lead into the septum during screwing. Two pitfalls-helix-only penetration and shallow penetration-hinder lead penetration. The research, conducted in 2 phases on patients and swine hearts, tested 2 techniques to overcome these issues. The results highlight the impact of endocardial involvement and suggest that the optimal technique involves intentionally creating an endocardial breach rather than simply unscrewing and rescrewing. This solution could facilitate the procedure by minimizing the number of attempts to reach the pacing site and thus reducing the risk of complications.

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.