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- W2463850347 abstract "Introduction: Left ventricular (LV) lead placement via the coronary sinus (CS) at the target site remains suboptimal. The coronary venous system has multiple collateral channels between veins. The aim of this study was to evaluate the ease of accessing coronary vein collaterals in the target zone for LV lead placement. Methods: 50 consecutive patients undergoing CRT were enrolled. Target LV site for lead placement was determined using pre-implant echo to determine the latest activated segment. Following CS cannulation a hydrophilic 0.014 wire was passed from the CS sheath, through the anatomical target zone and then via collaterals back into the CS or right atrium. The time taken to perform this manoeuvre was measured. A 10-minute maximum time was applied. The use of sub-selectors was at the discretion of the operator. Results: 39 of 50 patients (78%) successfully had the wire placed via collaterals back into the CS within 10 minutes. The mean time was 3.3±2.7 minutes (range: 25 seconds to 10 minutes). 4 further patients had a wire passed back into the coronary sinus, but not incorporating the target LV area. There were no clinical or echocardiographic predictors of procedural success. Sub-selectors were used in 9 of the successful cases and 6 of the unsuccessful cases. Conclusion: Coronary vein collaterals are common. With standard equipment a wire can be readily passed through the targeted LV segment in the majority of patients, facilitating interventional techniques for LV lead placement. This approach may be further utilised by CRT implanters." @default.
- W2463850347 created "2016-07-22" @default.
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- W2463850347 date "2015-01-01" @default.
- W2463850347 modified "2023-09-30" @default.
- W2463850347 title "Coronary vein collaterals: Implications for Interventional cardiac resynchronisation therapy (CRT)" @default.
- W2463850347 doi "https://doi.org/10.1016/j.hlc.2015.06.301" @default.
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