© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.
A randomized evaluation of different approaches to coronary sinus venography during biventricular pacemaker implants
Institute of Cardiology, Department of Cardiovascular Medicine, Catholic University of the Sacred Heart Rome, Italy
AIM: Biventricular implantation procedures require contrast venography of the coronary sinus. The aim of our study was to evaluate the efficacy and safety of contrast venography obtained by direct manual contrast injection into the guiding catheter, compared with venography obtained after occlusion of the coronary sinus by a Swan–Ganz catheter.
METHODS: Eighty-three patients were randomly assigned to direct or occlusive venography technique. The primary endpoint was complication rate. The secondary endpoints were rate of and time required for an adequate venography, total dose of contrast medium and total procedure time.
RESULTS: Four dissections of the coronary sinus were observed with the occlusive venography technique group while no complications were observed with the direct venography technique group (p = 0.04). Rate of adequate venography was similar in the two groups (p = NS). The time needed for coronary sinus venography and the total dose of contrast medium was significantly lower in the direct venography technique group compared with the alternative (p < 0.0001 and p = 0.003, respectively); the total procedure time was not significantly different between the two groups (p = NS).
CONCLUSIONS: The direct venography technique shows a significantly lower incidence of complications and should be considered to be the first line approach to coronary sinus venography during biventricular pacemaker implantation.
Key Words: cardiac resynchronization therapy, coronary sinus venography, biventricular pacemaker implantation technique, biventricular pacing
*Corresponding author. Istituto di Cardiologia, Dipartimento di Medicina Cardiovascolare, Policlinico Universitario "Agostino Gemelli", L.go A. Gemelli, 8, 00168 Rome, Italy. Tel.: +39(0)6 30154187; fax: +39(0)6 3055535. E-mail address: giusepdemartino{at}libero.it (G. De Martino).
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  N. R. Van de Veire, J. D. Schuijf, G. B. Bleeker, M. J. Schalij, and J. J. Bax Magnetic resonance imaging and computed tomography in assessing cardiac veins and scar tissue Europace, November 1, 2008; 10(suppl_3): iii110 - iii113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. A. McAlister, J. Ezekowitz, N. Hooton, B. Vandermeer, C. Spooner, D. M. Dryden, R. L. Page, M. A. Hlatky, and B. H. Rowe Cardiac Resynchronization Therapy for Patients With Left Ventricular Systolic Dysfunction: A Systematic Review JAMA, June 13, 2007; 297(22): 2502 - 2514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. R. Van de Veire, J. D. Schuijf, J. De Sutter, D. Devos, G. B. Bleeker, A. de Roos, E. E. van der Wall, M. J. Schalij, and J. J. Bax Non-Invasive Visualization of the Cardiac Venous System in Coronary Artery Disease Patients Using 64-Slice Computed Tomography J. Am. Coll. Cardiol., November 7, 2006; 48(9): 1832 - 1838. [Abstract] [Full Text] [PDF]
|
|