| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:413-417
© 2003 The Society of Thoracic Surgeons
a Department of Cardiac Surgery, Erasme University Hospital, Brussels, Belgium
b Department of Cardiology, Erasme University Hospital, Brussels, Belgium
Accepted for publication February 21, 2003.
* Address reprint requests to Dr Jansens, Department of Cardiac Surgery, Erasme University Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.
e-mail: jjansens{at}ulb.ac.be
BACKGROUND: Cardiac resynchronization therapy (CRT) by pacing the left and right ventricles is an emerging option for treatment of severe heart failure with ventricular conduction disturbances. Stimulation through a coronary vein is currently the technique of choice to achieve left ventricular (LV) pacing. Unfortunately, this approach carries significant limitations and drawbacks. Therefore we explored robotic-enhanced thoracoscopic implantation of an epicardial lead as an alternative technique to stimulate the LV in cardiac resynchronization therapy.
METHODS: A total of 15 patients were included in this study. Right (atrial and ventricular) leads were implanted classically through the left subclavian vein. Robotic-enhanced thoracoscopy was then performed to implant the LV epicardial lead.
RESULTS: Of the 15 patients, 13 underwent successful endoscopic robotic cardiac resynchronization therapy. Two patients underwent conversion to a small thoracotomy. No perioperative complication occurred in the patients who did not undergo conversion. Acute and chronic LV lead thresholds were satisfactory in all patients, improving over time. All were subjectively and objectively improved at 4 months. As compared with conventional methods, the procedural cost was not significantly affected.
CONCLUSIONS: Based on this feasibility study, we believe that robotic LV epicardial lead implantation is a valuable option to achieve biventricular resynchronization therapy. It allows for more reproducible acute thresholds for LV pacing and sensing than does the percutaneous approach; enables fine tuning of the LV lead position, thus potentially providing optimal hemodynamic benefit; and avoids the pitfalls and limitations of the endovenous approach. Therefore it deserves further prospective studies to assess its place in the therapeutic armamentarium against heart failure.
This article has been cited by other articles:
|
|
 |
|
  A. Patwala, P. Woods, R. Clements, K. Albouaini, A. Rao, D. Goldspink, L.-B. Tan, A. Oo, and D. Wright A prospective longitudinal evaluation of the benefits of epicardial lead placement for cardiac resynchronization therapy Europace, October 1, 2009; 11(10): 1323 - 1329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons J. Am. Coll. Cardiol., May 27, 2008; 51(21): e1 - e62. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons Circulation, May 27, 2008; 117(21): e350 - e408. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Bonaros, T. Schachner, A. Oehlinger, E. Ruetzler, C. Kolbitsch, W. Dichtl, S. Mueller, G. Laufer, and J. Bonatti Robotically Assisted Totally Endoscopic Atrial Septal Defect Repair: Insights From Operative Times, Learning Curves, and Clinical Outcome Ann. Thorac. Surg., August 1, 2006; 82(2): 687 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Gabor, G. Prenner, A. Wasler, M. Schweiger, K. H. Tscheliessnigg, and F. M. Smolle-Juttner A simplified technique for implantation of left ventricular epicardial leads for biventricular resynchronisation using video-assisted thoracoscopy (VATS) Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 797 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Steendijk, S. A.F. Tulner, M. Wiemer, R. A. Bleasdale, J. J. Bax, E. E. van der Wall, J. Vogt, and M. J. Schalij Pressure-volume measurements by conductance catheter during cardiac resynchronization therapy Eur. Heart J. Suppl., August 1, 2004; 6(suppl_D): D35 - D42. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Puglisi, M. Lunati, A. G.M Marullo, S. Bianchi, M. Feccia, F. Sgreccia, I. Vicini, S. Valsecchi, F. Musumeci, and E. Vitali Limited thoracotomy as a second choice alternative to transvenous implant for cardiac resynchronisation therapy delivery Eur. Heart J., June 2, 2004; 25(12): 1063 - 1069. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
