Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Petritsch, B.
Minimalinvasive Methoden zur Einbringung Epikardialer Schrittmacherelektroden
[ Dissertation ] Graz Medical University; 2008. pp.86.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Knez Igor
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- Abstract:
- Background: Cardiac resynchronisation therapy (CRT) by pacing the left and right ventricles is an emerging option for treatment of severe heart failure with ventricular conduction disturbance. Currently, access through a coronary vein is the technique of choice to achieve left ventricular (LV) pacing. Unfortunately, this approach carries significant limitations and drawbacks. Study Design: Prospective, blinded, multicentric, clinical pilot-study testing the feasibility of the new constructed Double Disk lead (Medtronic model 13033) as a pure investigational device for solo attachment to the pericardium. Methods: At the Medical University of Graz, at the department for cardiac surgery a total of 6 patients (2 female, 4 male) received the Double Disk electrode. All patients wee in NYHA III IV. Study inclusion criteria were an end stage cardiomyopathy and a complete left bundle branch block in the ECG. Results: Mean ejection fraction (EF) was 26%, all patients were in NYHA III-IV and had undergone failed coronary sinus implantation attempts before. Mean operation time from touching pericardium to definitive delivery of the 2nd electrode tip was 19.3 minutes. During surgical procedures there were no serious adverse events, all patients were extubated promptly. At the 6 month follow-up electrophysiological measurements of the Double Disk electrode revealed stable thresholds. The mean threshold was 2.4 V at 0.5 ms. Average ventricular signal was 4.6 mV, while pacing impedance was 345 Ohm at 5.0 Volt. Conclusion: This concept offers a completely new way to fix epimyokardial electrodes. It is a good option to existing methods for cardiac resynchronization therapy. More results of this multicentric study will follow and hopefully help the new Double Disk electrode to a wider range of therapy possibilities.