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Cardiac Vein Accessibility According to Heart Diseases and Sex: Implications for Cardiac Resynchronization Therapy
Author(s) -
UHM JAESUN,
PARK JE WOOK,
LEE HANCHEOL,
KIM TAEHOON,
YOUN JONGCHAN,
JOUNG BOYOUNG,
PAK HUINAM,
KANG SEOKMIN,
LEE MOONHYOUNG
Publication year - 2016
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/pace.12843
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , heart failure , great cardiac vein , coronary vein , vein , venography , ejection fraction , artery , coronary sinus , thrombosis
Background Cardiac resynchronization therapy (CRT) is an important therapy in patients with heart failure (HF) and dyssynchrony. We performed the present study to elucidate clinical factors associated with cardiac vein accessibility. Methods In 255 consecutive patients (age, 48.7 ± 19.4 years; male, 126), cardiac venography was performed during CRT implantation or an electrophysiological study. We measured the diameters and the proximal branching angles of the lateral cardiac and posterior ventricular veins. Easy accessibility of the cardiac vein was defined as a lumen diameter ≥1.6 mm with an angle of ≥90°. We compared baseline characteristics between patients with and without easily accessible cardiac veins. We compared cardiac vein accessibility between patients with and without HF, including ischemic and nonischemic HF, and between males and females. Results In 189 (74.1%) patients, the cardiac veins were easily accessible. The cardiac veins were more easily accessible in patients with HF (n = 75) compared with patients without HF (n = 180; 89.3% and 67.8%, respectively; P < 0.001). The cardiac veins were more easily accessible in patients with nonischemic HF (n = 56) compared with patients with ischemic HF (n = 19; 96.4% and 68.4%, respectively; P = 0.003). The cardiac veins were more easily accessible in females compared with males (79.8% and 68.3%, respectively; P = 0.035). Conclusions Accessing the cardiac veins for CRT implantation was difficult in ∼10% of patients with HF. Cardiac vein accessibility was high in patients with nonischemic HF and in females.