Single-lead VDD pacemaker implantation via persistent left superior vena cava: an improved technique and a new modality.
Single-lead VDD pacemaker implantation via persistent left superior vena cava: an improved technique and a new modality.
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通过持续性左上腔静脉植入单导联 VDD 起搏器：改进的技术和新的模式。
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发表时间：
1998
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通讯作者：
Kong Cw
中科院分区：
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作者：
Hiao Hc;Chang Hy;Kong Cw
持续性左上级腔静脉（PLSVC）发生在约0.5%的普通人群中，可能会使起搏器植入复杂化，因为在尝试经静脉入路时，会使电极导线插入右心室更加困难并增加电极导线的不稳定性。我们描述了我们的经验与四个PLSVC患者的起搏器。我们开发了一种开放式J形环技术，其中探针尖端指向三尖瓣口的前方。将电极导线植入右心室心尖部，没有遇到任何困难。我们的三名患者患有高度房室传导阻滞，并接受了VVI起搏器与新技术。1例完全性房室传导阻滞患者采用相同技术植入单导联VDD起搏器，将成对电极置于右心房下部。运动耐量试验、24小时动态霍尔特监测和超声心动图测定的收缩和舒张功能均获得了良好的结果。这种改进的技术可以简化PLSVC患者的起搏器植入。VDD器械是维持收缩和舒张功能的一种新方法，是需要植入起搏器的高度房室传导阻滞和PLSVC患者的适当选择。
: Persistent left superior vena cava (PLSVC), which occurs in approximately 0.5% of the general population, may complicate pacemaker implantation by making lead insertion into the right ventricle more difficult and increasing lead instability when the transvenous approach is attempted. We describe our experience with four PLSVC patients with pacemakers. We developed an open J-loop technique in which the stylet tip is directed toward the orifice of the tricuspid valve anteroinferiorly. The lead was implanted into the right ventricular apex without difficulty. Three of our patients had high-degree atrioventricular block and received VVI pacemakers with the new technique. One patient with complete atrioventricular block received a single-lead VDD pacemaker by means of the same technique, with the paired electrodes positioned in the lower right atrium. Excellent results were obtained on exercise tolerance testing, 24-hour Holter monitoring, and echocardiographically determined systolic and diastolic function. This improved technique can simplify pacemaker implantation in patients with PLSVC. The VDD device is a new way to maintain systolic and diastolic function and is an appropriate option in patients with high-degree atrioventricular block and PLSVC who require pacemaker implantation.