Efficacy of coronary sinus reducer implantation in patients  with chronic total occlusion of the right coronary artery

Mrak, Miha; Pavšič, Nejc; Ponticelli, Francesco; Beneduce, Alessandro; Palmisano, Anna; Guarracini, Stefano; Esposito, Antonio; Banai, Shmuel; Žižek, David; Giannini, Francesco; Bunc, Matjaž

doi:10.33963/kp.a2021.0132

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…All patients were discharged on the following day after the implantation procedure. Similar to our findings, recently published data confirmed the safety and efficacy of the procedure [7][8][9][10][11]. Nevertheless, we observed a slightly higher success rate in comparison to other studies.…”

Section: Resultssupporting

confidence: 92%

Coronary Sinus Reducer implantation in refractory angina: Short-term outcomes based on the Lower Silesia Sinus Reducer Registry (LSSRR)

Włodarczak¹,

Rola

Jastrzębski³

et al. 2023

Kardiol Pol

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Section: Resultssupporting

confidence: 92%

Coronary Sinus Reducer implantation in refractory angina: Short-term outcomes based on the Lower Silesia Sinus Reducer Registry (LSSRR)

Włodarczak¹,

Rola

Jastrzębski³

et al. 2023

Kardiol Pol

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“…The characteristics of the included studies are presented in Table 1 (Ref. [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]). Twelve studies with a total of 1679 patients undergoing CSR implantation were evaluated.…”

Section: Resultsmentioning

confidence: 99%

The Efficacy of Coronary Sinus Reducer in Patients with Refractory Angina: A Systematic Review and Meta-Analysis

Theofilis,

Vlachakis,

Sagris

et al. 2024

Rev. Cardiovasc. Med.

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Background: Refractory angina is a frequently encountered phenomenon in patients with coronary artery disease, often presenting therapeutic challenges to the clinical cardiologist. Novel treatment methods have been explored in this direction, with the coronary sinus reducer (CSR) being among the most extensively-investigated. Methods: We conducted a systematic review of the literature for studies assessing the efficacy of CSR in patients with refractory angina. The primary endpoints of interest were procedural success and the improvement in angina according to the Canadian Cardiovascular Society (CCS) by at least one class. Secondary endpoints were the rate of periprocedural adverse events, the improvement by at least 2 CCS classes, and the mean change in CCS class. A random-effects meta-analysis of proportions (procedural success, improvement by 1 or 2 classes, periprocedural adverse events) or means (mean CCS class change) were performed. was chosen as the metric for between-study heterogeneity. Publication bias was assessed by the inspection of funnel plots and Egger’s regression test. We examined the risk of bias according to the Newcastle-Ottawa Scale. Results: From a total of 515 studies identified from the original search, 12 studies were finally included for data extraction. Based on their meta-analysis, we observed a high CSR procedural success (98%, 95% confidence interval (CI) 96 to 99%) with a low rate of periprocedural complications (6%, 95% CI 5 to 7%), while most patients exhibited an improvement by at least 1 CCS class (75%, 95% CI 66 to 83%) after the intervention. A significant proportion of patients demonstrated an improvement by at least 2 CCS classes (39%, 95% CI 34 to 45%), with a mean change of –1.24 CCS class (95% CI –1.40 to –1.08). Conclusions: CSR is associated with high implantation success rates and significant improvements in angina symptoms for patients with refractory angina.

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“…Both studies were randomized and blinded with a sham procedure. Some non-randomized studies also showed the improvement of left ventricular perfusion by SPECT or magnetic resonance imaging [ 14 , 15 , 16 , 17 ]. However, potential antiarrhythmic effects were not assessed.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Coronary Sinus Reducer on Arrhythmic Properties in Patients with Refractory Angina

Mrak,

Žlahtič,

Starc

et al. 2023

Rev. Cardiovasc. Med.

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Background: Treatment with a coronary sinus reducer (CSR) is a new therapeutic option for refractory angina patients. Preclinical studies have shown antiarrhythmic properties of coronary sinus narrowing. The possible antiarrhythmic effect of CSR implantation is unknown. This study aimed to determine the possible antiarrhythmic effects of CSR implantation as assessed by high-resolution electrocardiogram (hrECG) parameters. Methods: 24 patients from the Crossroad study randomized to either CSR treatment (n = 12) or a sham procedure (n = 12) had hrECG recorded at baseline and after 6 months. T-peak and T-end interval (TpTe) defined as the time difference between the peak amplitude of the T wave and the global end of the T wave, spatial angle between QRS complex and T axis defined as the angle between the ventricular depolarization and repolarization vectors using maximal (QRSTP) and mean (QRSTM) vector amplitudes and spatial ventricular gradient (SVG) calculated as integral of ECG voltages over the entire QRST complex were analyzed. Additionally, we analyzed parameters of QT and heart rate variability using time and frequency domain. Results: At baseline, all analyzed parameters were comparable between both groups and heart rate remained constant. The intragroup analysis did not show any significant change in TpTe, QRSTP, QRSTM, SVG, QT, and heart rate variability at follow-up. Furthermore, intergroup comparison between CSR implantation and sham procedure also did not show any significant difference in the change of analyzed parameters. Conclusions: Compared to the sham procedure, CSR implantation did not demonstrate a significant impact on the arrhythmogenic substrate assessed with hrECG. Clinical Trial Registration: Unique Identifier: NCT04121845, .

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Efficacy of coronary sinus reducer implantation in patients with chronic total occlusion of the right coronary artery

Cited by 9 publications

References 18 publications

Coronary Sinus Reducer implantation in refractory angina: Short-term outcomes based on the Lower Silesia Sinus Reducer Registry (LSSRR)

Coronary Sinus Reducer implantation in refractory angina: Short-term outcomes based on the Lower Silesia Sinus Reducer Registry (LSSRR)

The Efficacy of Coronary Sinus Reducer in Patients with Refractory Angina: A Systematic Review and Meta-Analysis

The Impact of Coronary Sinus Reducer on Arrhythmic Properties in Patients with Refractory Angina

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