新型冠状窦造影球囊导管在心脏再同步治疗起搏器植入术中的应用  

Application of a new kind of coronary sinus angiography balloon catheter in cardiac resynchronization therapy pacemaker implantation

作　　者：段江波[1] 何金山[1] 王龙[1] 李鼎[1] 昃峰[1] 吴寸草[1] 周旭 杨丹丹 周晶亮 李学斌[1] Duan Jiangbo;He Jinshan;Wang Long;Li Ding;Ze Feng;Wu Cuncao;Zhou Xu;Yang Dandan;Zhou Jingliang;Li Xuebin(Department of Cardiology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院心内科,100044

出　　处：《中国心血管杂志》2022年第1期28-31,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的评估新型冠状窦造影球囊导管在心脏再同步治疗(CRT)起搏器植入术中应用的有效性和安全性。方法连续入选2019年1月1日至12月1日于北京大学人民医院心内科就诊的具有CRT起搏器(包括CRT-P和CRT-D)植入指征的患者25例,排除既往植入失败和拒绝签署知情同意书者5例,符合入选标准的20例患者应用新型冠状窦造影球囊导管进行CRT植入,统计这些患者CRT植入时间、左室电极植入时间、冠状窦夹层和心包积液发生率,计算CRT植入成功率。结果20例患者中,男性12例,平均年龄(62.3±4.5)岁,缺血性心肌病6例,平均纽约心脏病协会(NYHA)心功能分级(2.5±0.8)级,平均左室舒张末期内径(52.6±3.3)mm,平均射血分数38.0%±5.0%,平均左室电极植入时间(12.3±2.4)min,平均手术时间(54.6±6.2)min,CRT总体植入成功率100%。全部患者均无膈肌刺激,均未发生冠状窦夹层,术中无患者发生心脏压塞,术后复查超声心动图均无新发心包积液。结论新型冠状窦造影球囊导管能够在较短时间内完成CRT左室电极植入,与既往植入方法相比,可减少术中X线曝光时间,降低冠状静脉夹层发生率,提高CRT植入成功率。Objective To evaluate the safety and effectiveness of a new kind of coronary sinus angiography balloon catheter in cardiac resynchronization therapy(CRT)pacemaker implantation.Methods From January 1,2019 to December 1,2019,25 consecutive patients who had indications for CRT implantation were selected,5 patients were excluded for prior implantation failure and refuse to sign agreements,20 patients who met the selection criteria were treated with CRT implantation using the new kind of coronary sinus angiography balloon catheter.We recorded the procedure time,left ventricular lead implantation time,rate of coronary sinus dissection and cardiac tamponade,and calculated the rate of success CRT implantation to evaluate the efficiency and safety of this new catheter.Results Among the 20 patients,12 were male,the average age of(62.3±4.5)years,6 of them had ischemic cardiomyopathy,14 had non-ischemic cardiomyopathy,the NYHA class was 2.5±0.8,the left ventricle diastolic diameter was(52.6±3.3)mm and ejection fraction was 38.0%±5.0%,the average time for procedure was(54.6±6.2)min and(12.3±2.4)min for left ventricular lead implantation.The overall rate of success CRT implantation was 100%.No patients had coronary sinus dissection and new pericardial effusions.Conclusions Compared with the previous implantation methods,the new kind of coronary sinus angiography balloon catheter can help shorten the time of CRT implantation and reduce x-ray exposure,meanwhile,it can help lower the risk of coronary sinus dissection and increase the rate of success CRT implantation.

关 键 词：冠状窦造影导管 心脏再同步治疗 除颤器 植入型 电极 植入 冠状窦夹层 心脏压塞 成功率 

分 类 号：R541.6[医药卫生—心血管疾病]