Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy

Doblado-Calatrava, Manuel; Sánchez‐Quintana, Damián; García-Guerrero, Juan José; Pizarro, Gonzalo; Concha, Joaquín Fernández de la

doi:10.1016/j.hrcr.2015.06.003

Cited by 2 publications

(5 citation statements)

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“…The endocardial procedure was successful in 100% of the patients in our series; only two of them required a second attempt (due to LV electrode dislodgement and unstable angina, respectively, during the initial procedure). In our opinion, the use of ICE to monitor the position of the LV lead was of great help in our 22 cases using the IVS puncture technique; nevertheless, the group that reported the first 10 cases of this technique achieved similar success without this additional element . Our mean implant time was faster than has been reported by others and comparable to that of Moriña‐Vázquez et al; mean fluoroscopy time was comparable to all of these series …”

Section: Discussionsupporting

confidence: 80%

Left ventricular endocardial pacing in the real world: Five years of experience at a single center

Guerrero

Castañeda

Calatrava

et al. 2019

Pacing Clinical Electrophis

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Background A left ventricular (LV) endocardial lead implant to achieve cardiac resynchronization therapy (CRT) is feasible when a conventional implant failed due to anatomical or technical issues or when the venous implant was performed but the patient did not respond to the therapy. Methods Data about the implantation procedure (age, sex, clinical characteristics, anticoagulant use, and previous devices), patient characteristics (indication, technique used, lead model, complications), and follow‐up (clinical and echocardiographic outcome, LV lead electrical measurements) were analyzed for all CRT systems implanted using LV endocardial lead, due to failed conventional implant or nonresponse, between April 2011 and November 2016. Results Thirty‐five patients were implanted with an active fixation LV endocardial lead during the study period, without significant complications. There were no dislodgements or severe complications related to the implant procedure in the follow‐up period (36 ± 20 months) and a high percentage of patients responded to therapy, as assessed by several indicators. Conclusions An LV endocardial lead implant was feasible when the conventional technique had previously failed or was not effective. A high rate of response was achieved without any significant complications.

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Section: Discussionsupporting

confidence: 80%

Left ventricular endocardial pacing in the real world: Five years of experience at a single center

Guerrero

Castañeda

Calatrava

et al. 2019

Pacing Clinical Electrophis

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“…Current available puncture devices mainly included Brockenbrough needle and radiofrequency needle/ guidewire. [1][2][3][4][5][6][7][8][9][10] For the former, it was very stiff and not suitable for the puncture of IVS. For the latter, they might lead to surrounding collateral damage alone the tract of puncture.…”

Section: Discussionmentioning

confidence: 99%

“…In this research, the puncture seemed easy once the location and direction were determined and the needle contacted firmly on the left side of IVS. Current available puncture devices mainly included Brockenbrough needle and radiofrequency needle/guidewire . For the former, it was very stiff and not suitable for the puncture of IVS.…”

Section: Discussionmentioning

confidence: 99%

“…Via superior vena cava and the puncture of interventricular septum (IVS), an available communication of IVS has been reported, which facilitated left ventricle (LV) endocardial ablation or pacing transvenously. [1][2][3][4][5][6][7][8][9][10] The novel approach might have wider clinical application, especially in transcatheter intervention of mitral/aortic valve. 3 Through subclavian/jugular vein, however, the approach resulted in the acute entry-angle, which was not suitable for transvenous introduction of large and stiff delivery sheath.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transfemoral transcatheter puncture of interventricular septum in a swine model: A novel transfemoral‐venous access to left ventricle with the assistance of arterio‐venous circuit

Yan

Wan

et al. 2020

Cathet Cardio Intervent

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Objective: Via subclavian/jugular vein, successful puncture of interventricular septum (IVS) has been achieved transvenously. However, the approach was limited by acute entry-angle. The study was conducted to investigate a novel transcatheter puncture of IVS via femoral access and transfemoral-venous access to left ventricle (LV) through IVS. Methods: Via femoral artery, transcatheter puncture of mid-IVS was performed with a custom-made nickel-titanium needle and 6F-sheath in 16 healthy mini-swine. Then femoral arterio-venous circuit was established through IVS. After pre-dilation of IVS, a 20F-sheath was introduced into LV transvenously over-the-guidewire in 15 swine. Furthermore, transfemoral-venous TAVR was attempted with the approach in another swine. IVS was evaluated postoperatively and was further confirmed pathologically 2 months later. Results: All transcatheter puncture of IVS was performed successfully in LV and the mid-IVS thickness was 7.67 ± 0.98 mm. In all swine, femoral arterio-venous circuit was established via IVS, and a 20F-sheath was introduced into LV and aorta transfemoral-venously (entry-angle: 145.3 ± 12.2 in front view). After the procedure, there was one swine with moderate tricuspid-regurgitation and five swine with mild residual-shunt (2.6 ± 0.7 mm). Two months later, residual-shunt was still detected in three swine and the communication was confirmed pathologically. In other swine, no defect occurred and replacement-scar was identified along puncturetract. In the swine underwent transfemoral-venous TAVR, prosthetic valve was deployed successfully with good function. Conclusions: Transfemoral transcatheter puncture of IVS is feasible and safe in a swine model, and large sheath can be introduced into LV transfemoral-venously using the novel access with the aid of vessel circuit.

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Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy

Cited by 2 publications

References 4 publications

Left ventricular endocardial pacing in the real world: Five years of experience at a single center

Left ventricular endocardial pacing in the real world: Five years of experience at a single center

Transfemoral transcatheter puncture of interventricular septum in a swine model: A novel transfemoral‐venous access to left ventricle with the assistance of arterio‐venous circuit

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