Clinical Study Of Implantation Of Left Ventricular Pacing Lead

Background: The treatment of congestive heart failure is the challenge for physicians all the time. The incidence of heart failure has been increasing gradually, with the intensifying of population aging and the improvement of the treatment about myocardial infarction. All around the world the number of people with heart failure(HF) is up to 22.5 million. A data from a Chinese institution showed that the number of Chinese people with HF, in the age from 35-74 years, is about 40 million. At present, the clinically available drug therapy for HF, can significantly prolong life in patients, however not all patients respond positively to treatment. Fortunately, the cardiac resynchronization therapy(CRT) or cardiac resynchronization therapy with defibrillator(CRT-D), as a significant medical advance in HF therapy, has become an effective treatment strategy. The location of left ventricular lead, which is relative to the effect of this therapy, plays an important part in the CRT treatment.Metheds: There are 33 patients, males in 21 and females in 12, mean age of 58.1 years old, with congestive heart failure and intraventricular conduction delay. Among of them, there were 31 patients with dilated cardiomyopathy and 2 patients with ischemic cardiomyopathy. Venography was performed in all atients. The different type of coronary sinus leads were used to pacing left ventricle. The left ventricular pacing threshold wastested during the procedure.Results: 33 patients were attempted to implant left ventricular lead through coronary sinus. There were 30 patients who had successful implantation. The success rate was 90.9%. The left ventricular lead was implanted in branch of coronary sinus, 4 in great cardiac vein, 2 in latherier vein, 16 in latherierposterior vein, 7 in posterior vein and 1 in middle cardiac vein. The left ventricular pacing threshold was 1.39V. There were no complications except 1 patient had dissection in coronary sinus.Conclusion: It is feasible and safe to pace left ventricle lead through coronary sinus. The optimal lacation for left ventricular lead implantion can be archieved in the lateral and the posterior lateral vein or sometimes in the middle vein. Proper choice can minimize the occurance of complication.