Analysis Of Related Factors And Prognosis Of Coronary Venous System Injury In Cardiac Resynchronization Therapy

Objective: To analyze the factors associated with coronary venous system injury caused by left ventricular electrode wire implantation during cardiac resynchronization therapy(CRT)surgery.Methods:A total of 706 patients with heart failure(heart failure)who underwent CRT in the First Affiliated Hospital of Xinjiang Medical University from June 2002 to June 2021 were collected,105 patients who did not meet the inclusion criteria were excluded,and a total of 601 patients who underwent CRT for the first time were included.Patients implanted or upgraded to CRT and left ventricular lead replacement.The intraoperative results and related factors of coronary venous system injury were analyzed,and the median postoperative hospital stay was compared between the injured group and the non-injured group.Scale model to analyze the effect of coronary venous system injury on the risk of rehospitalization for heart failure in patients.Results: Coronary venous system injury occurred in 19 patients with an incidence rate of 3.16%,including 17 patients(89.47%)with simple dissection and 2 patients(10.53%)with coronary vein perforation.In patients with simple coronary dissection,11 patients(64.70%)continued to successfully implant left ventricular lead,and 1 patient(50.00%)with coronary perforation continued to successfully implant left ventricular lead.Coronary vein injury did not increase the operative mortality,lead dislocation or bag infection and other complications,but prolonged the postoperative hospital stay [5(3,7)vs 7(6,8),P<0.05 ],increased the rate of rehospitalization due to heart failure within 6 months [85(14.60%)vs 6(31.58%),P=0.042],Cox analysis showed that patients with coronary vein injury compared with patients without coronary venous system injury occurred The risk of rehospitalization due to heart failure increased by 165.8%(HR=2.658,95%CI: 1.132-6.241,P=0.025).Conclusion:Coronary vein injury can occur during CRT implantation.After the injury,there is still a chance to continue to successfully implant the left ventricular lead,but it prolongs the postoperative hospital stay,and increases the patient’s rehospital rate and risk of rehospitalization due to heart failure.