- 作者：Andrea Colella ; MD* ; colella.eplab@gmail.com" class="auth_mail" title="E-mail the corresponding author ; Marzia Giaccardi ; MD&dagger ; ; Tommaso Colella ; MD&Dagger ; ; Pietro Amedeo Modesti ; MD ; PhD* ; &Dagger ;
- 关键词：Pacemakers ; Intracardiac defibrillators ; Imaging ; Heart failure ; Cardiac resynchronization therapy
- 刊名：Heart Rhythm
- 出版年：2016
- 出版时间：July 2016
- 年：2016
- 卷：13
- 期：7
- 页码：1481-1488
- 全文大小：1096 K
Objective
The aim of our study was to investigate the feasibility and reliability of biventricular device implantation guided only by an electroanatomic navigation system.
Methods
Sixty-one patients with heart failure underwent implantation of a cardiac resynchronization therapy (CRT) device with or without defibrillator (CRT-D; CRT-P). The procedure was performed with or without fluoroscopy guidance (Rx+; Rx0). In the latter case, the EnSite Velocity system was used; this system is able to reconstruct the anatomy and activation of the cardiac chambers by simultaneously collecting a “cloud” of anatomical points from multiple electrodes.
Results
Lead positioning was achieved in 24 of 26 patients undergoing CRT implantation without fluoroscopy (92% success). No complications were observed during the procedure and no catheter dislodgment occurred the day after the implantation or during 1-month follow-up. Procedure time progressively decreased from 136 minutes in the first case to 59 minutes in the last one, suggesting that operators gradually gained confidence while using the new technique.
Conclusion
Our study demonstrates the feasibility, efficacy, and safety of lead positioning guided only by the nonfluoroscopic EnSite Velocity mapping system without the use of fluoroscopy in CRT-P or CRT-D implantation. The benefits in terms of significantly reduced fluoroscopy exposure are associated with technical and clinical advantages.