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Usefulness of a Pacing Guidewire to Facilitate Left Ventricular Lead Implantation in Cardiac Resynchronization Therapy
Author(s) -
DE COCK CAREL C.,
RES JAN C. J.,
HENDRIKS MATTHIJS L.,
ALLAART CORNELIS P.
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02303.x
Subject(s) - medicine , cardiac resynchronization therapy , lead (geology) , fluoroscopy , phrenic nerve , cardiology , cardiac pacing , heart failure , surgery , respiratory system , ejection fraction , geomorphology , geology
Background: Intraoperative measurements of left ventricular (LV) pacing and sensing values were assessed using a novel 0.014‐inch guidewire (Visionwire ® , Biotronik GmbH, Berlin, Germany) enabling pacing and sensing at the distal tip before final LV lead implantation .Methods: Twenty‐two consecutive patients selected for cardiac resynchronization therapy were studied .Results: Significant correlation was found between the LV pacing threshold as assessed by the Visionwire ® and values after final LV lead implantation (r = 0.92, P < 0.001). Correlation for LV sensing was also significant (r = 0.72, P < 0.001). No significant correlation was present with respect to phrenic nerve stimulation. However, no phrenic nerve stimulation at 10 V/0.5 ms using the Visionwire ® identified 88% of patients without phrenic nerve stimulation at 10 V/0.5 ms with subsequent LV lead measurements .Conclusion: This technique may facilitate transvenous LV lead implantation by preventing implantation in a unsuitable target vessel with respect to pacing and sensing values or phrenic nerve stimulation, thereby reducing procedure and fluoroscopy time .