Safety and Feasibility of Cephalic Venous Access for Cardiac Resynchronization Device Implantation.
Cardiac resynchronization therapy (CRT) devices are usually implanted using subclavian vein access, which is associated with the risk of pneumothorax. We examined whether cephalic venous access is an effective alternative to subclavian access by the Seldinger technique for CRT delivery. We retrospec...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 34; no. 3; pp. 365 - 370 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104838638&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104838638 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Mar2011 vid: 34 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104838638 59161641 10.1111/j.1540-8159.2010.02975.x NLM21091741 104838638 ppf: 365 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Safety and Feasibility of Cephalic Venous Access for Cardiac Resynchronization Device Implantation. aug: au: Ussen, Bassey Dhillon, Paramdeep S. Anderson, Lisa Beeton, Ian Hickman, Mike Gallagher, Mark M. affil: Department of Cardiology, St. George's Hospital, London, UK sug: subj: Pacemaker, Artificial Methods Brachiocephalic Veins Surgery Heart Failure Therapy Cardiac Resynchronization Therapy Retrospective Design Descriptive Statistics Unpaired T-Tests Fisher's Exact Test Human Male Female Aged, 80 and Over Aged Middle Age Time Factors Treatment Outcomes Pilot Studies Aged, 80 & over Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Cardiac resynchronization therapy (CRT) devices are usually implanted using subclavian vein access, which is associated with the risk of pneumothorax. We examined whether cephalic venous access is an effective alternative to subclavian access by the Seldinger technique for CRT delivery. We retrospectively analyzed all CRT procedures performed over a 1-year period at our center with respect to the access methods, primary success rate, safety, and efficiency. We retrospectively analyzed 103 consecutive primary implantation procedures. The procedure was accomplished using cephalic access alone for 54 of 61 (89%) CRT implants attempted by this route. The overall success rate was 100% (61/61) with additional use of subclavian access. CRT implantation via subclavian vein access was successful in 37 of 42 (88%) (P < 0.05 vs cephalic group). The procedure duration was shorter for the cephalic group (118 ± 39 vs 147 ± 36 minutes, P < 0.0005) as were the screening times and radiation exposure (15 ± 9 vs 27 ± 18 minutes and 4.7 ± 5.8 vs 9.3 ± 9.1 Gcm, both P < 0.01). In the cephalic group, procedure duration and radiation exposure diminished significantly with increasing experience of the technique. Complications occurred in two of 61 (3.3%) cases in the cephalic group and three of 42 (7.1%) in the subclavian group (P = NS). CRT devices can be implanted using cephalic access alone in a large majority of cases. This approach is safe and efficient. (PACE 2011; 34:365-369) pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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