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Three-Dimensional Electroanatomic Mapping System-Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry
- Source :
- Journal of Cardiovascular Electrophysiology. 28:85-93
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Electroanatomic Mapping for CRT Implantation RegistryIntroduction Cardiac resynchronization therapy (CRT) device implantation guided by an electroanatomic mapping system (EAMS) is an emerging technique that may reduce fluoroscopy and angiography use and provide information on coronary sinus (CS) electrical activation. We evaluated the outcome of the EAMS-guided CRT implantation technique in a multicenter registry. Methods During the period 2011–2014 we enrolled 125 patients (80% males, age 74 [71–77] years) who underwent CRT implantation by using the EnSite system to create geometric models of the patient's cardiac chambers, build activation mapping of the CS, and guide leads positioning. Two hundred and fifty patients undergoing traditional CRT implantation served as controls. Success and complication rates, fluoroscopy and total procedure times in the overall study population and according to center experience were collected. Centers that performed ≥10 were defined as highly experienced. Results Left ventricular lead implantation was successful in 122 (98%) cases and 242 (97%) controls (P = 0.76). Median fluoroscopy time was 4.1 (0.3–10.4) minutes in cases versus 16 (11–26) minutes in controls (P < 0.001). Coronary sinus angiography was performed in 33 (26%) cases and 208 (83%) controls (P < 0.001). Complications occurred in 5 (4%) cases and 17 (7%) controls (P = 0.28). Median fluoroscopy time (median 11 minutes vs. 3 minutes, P < 0.001) and CS angiography rate (55% vs. 21%, P < 0.001) were significantly higher in low experienced centers, while success rate and complications rate were similar. Conclusions EAMS-guided CRT implantation proved safe and effective in both high- and low-experienced centers and allowed to reduce fluoroscopy use by ≈75% and angiography rate by ≈70%.
- Subjects :
- medicine.medical_specialty
Electroanatomic mapping
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Cardiac resynchronization therapy
030204 cardiovascular system & hematology
medicine.disease
Implantable cardioverter-defibrillator
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
Heart failure
Angiography
medicine
Fluoroscopy
030212 general & internal medicine
Radiology
Cardiology and Cardiovascular Medicine
Complication
business
Coronary sinus
Subjects
Details
- ISSN :
- 10453873
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi...........2781dd8074f339005938c47698a1c056