Was ist die ideale Position für LV-Sonden zur effektiven kardialen Resynchronisationstherapie (CRT)?

Abstract

Cardiac Resynchronisation Therapy (CRT) is an effective tool in the treatment of chronic heart failure (CHF) and asynchronous contraction of the left ventricle caused by left bundle branch block. The potency of resynchronisation effect by CRT depends on an ideal position of the left ventricular stimulation lead in a postero-lateral branch of the coronary sinus (CS) or ideal epicardial location. For positioning in suitable locations of the CS lead oblique fluoroscopy projections are useful. The best performance in consideration of CRT effect are achievable with CS lead positioning in the postero-lateral segment (LAO-projection) and basal or middle segment (RAO-projection). Apical positioning of CS lead is associated with lower CRT effect and excess mortality. After implantation of CRT systems the optimisation of AV- and VV-delay can improve CRT-effect and clinical performance of this critical ill patients.

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