title: Coronary sinus cannulation with a steerable catheter during biventricular device implantation.
abstract: OBJECTIVE
  To determine whether a steerable catheter with electrogram guidance (CS-assist group) could facilitate access to the coronary sinus (CS) during cardiac resynchronization therapy (CRT) implantation.
  
  
  METHODS
  Consecutive patients who underwent CRT implantation were recruited prospectively into the CS-assist group (n = 81) and compared with those using conventional techniques without an electrogram guidance (conventional group, n = 101).
  
  
  RESULTS
  The CS cannulation success rate was clearly greater in the CS-assist group (100%) than that in the conventional group (95%, p < 0.05), with significantly shorter mean procedure time (52.6 ± 20.6 min vs. 73.2 ± 40.9 min, p < 0.01) and fluoroscopy time (3.6 ± 3.2 min vs. 14.2 ± 20.4 min, p < 0.01). In the five CS cannulation failure cases, mean procedure time (144.0 ± 37.0 min) and fluoroscopy time (57.8 ± 24.8 min) were significantly longer than those in the other patients (61.2 ± 32.3 and 8.2 ± 13.6 min, respectively, n = 177, both p < 0.01).
  
  
  CONCLUSIONS
  Using the steerable catheter with real-time electrogram guidance, location of and access to the CS is more rapid and successful, which may improve the success of the CRT implantation and may give significant time savings.
authors.affiliation: Department of Arrhythmias, Skane University Hospital, Lund University , Lund , Sweden.
authors.forename: Lingwei
authors.initials: L
authors.lastname: Wang
authors.forename: Shiwen
authors.initials: S
authors.lastname: Yuan
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Höijer
authors.forename: Johan
authors.initials: J
authors.lastname: Brandt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000295:instrumentation*; D062906:Cardiac Catheters; D058406:Cardiac Resynchronization Therapy; D058409:Cardiac Resynchronization Therapy Devices; D054326:Coronary Sinus / Q000000981:diagnostic imaging / Q000503:physiopathology; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome