Cardiac Resynchronization Therapy Clinical Studies Of Congestive Heart Failure

Background: Previous studies have suggested that biventricular pacing could improve heart function in patients with congestive heart failure and intraventricular conduction delay. The most important technique is implantation of left ventricular lead. This study is to evaluate the left ventricular pacing technique through coronary sinus.Methods: There are 70 patients, males in 54 and females in 16, mean age of 52 years old, with congestive heart failure and intraventricular conduction delay. Among of them, there were 56 patients with dilated cardiomyopathy and 14 patients with ischemic cardiomyopathy. Venography was performed in all patients. The different type of coronary sinus leads were used to pacing left ventricle. The left ventricular pacing threshold was tested during the procedure.Results: 73 patients were attempted to implant left ventricular lead through coronary sinus. There were 70 patients who had successful implantation. The success rate was 96%. The left ventricular lead was implanted in branch of coronary sinus, 16 in great cardiac vein, 9 in latherier vein, 21 in latherier posterior vein, 23 in posterior vein and 2 in middle cardiac vein. The left ventricular pacing threshold was 1.48V. There were no complications except 2 patients had dissection in coronary sinus. Conclusions: It is feasible and safe to pace left ventricle through coronary sinus. The successful implantation rate will be improved with the progress of lead technique and more clinical experience.