- 著者
- Ki-Hun Kim Kyoung-Min Park Gi-Byoung Nam Dae-Kyeong Kim Minkyung Oh HyungOh Choi Taek Jong Hong Bo-Min Park Guang-Won Seo Pil-Sang Song Dong-Kie Kim Sang-Hoon Seol Doo-IL Kim You-Ho Kim Kee-Joon Choi
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.78, no.4, pp.865-871, 2014 (Released:2014-03-25)
- 参考文献数
- 18
- 被引用文献数
- 9 28
Background: Long-term data on lead complication rates are limited for both the axillary and subclavian venous approaches for permanent pacemaker implantation. Methods and Results: We conducted a single-center, retrospective, nonrandomized comparison. We reviewed the patients who had consented to receiving a permanent pacemaker implant. A superficial landmark or radiographic contrast guiding was used for the axillary venous approach, whereas conventional landmarks were used for the subclavian venous approach. From January 1992 to December 2005, we analyzed 1,161 permanent pacemaker leads in 655 patients [subclavian venous approach (group I: 338 patients, 542 leads) and axillary venous approach (group II: 317 patients, 619 leads)]. Baseline characteristics of the patients did not differ. However, DDD-pacemakers and atrial leads were used more often in group II than in group I (94% vs. 62% and 49% vs. 40%, P<0.01). During the 8-year follow-up, lead complication rates were lower in group II (17 leads, 3%) than in group I (31 leads, 6%) (P=0.03), and group II had a better complication-free survival curve than group I with a 49% relative risk reduction in lead complication rates (hazard ratio =0.51; 95% confidence interval, 0.27–0.94; P=0.03). Conclusions: The axillary venous approach for permanent pacemaker implantation has better long-term efficacy and lower lead complication rates than the subclavian venous approach. (Circ J 2014; 78: 865–871)
- 著者
- Ki-Hun Kim Gi-Byoung Nam Eun-Sun Jin Dong-Kie Kim Sang-Hoon Seol Doo-Il Kim HyungOh Choi Yoo Ri Kim Sung-Hwan Kim Kee-Joon Choi You-Ho Kim
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.77, no.3, pp.619-625, 2013 (Released:2013-02-25)
- 参考文献数
- 22
- 被引用文献数
- 5 5
Background: Prompt diagnosis and management of atrial tachyarrhythmias (ATAs) during catheter ablation of atrial fibrillation (AF) is still challenging. Methods and Results: In 88 patients undergoing catheter ablation of AF, 128 regular ATAs were induced or converted from AF. The coronary sinus activation time (CSAT) around the mitral annulus (MA) was measured as the difference in activation time between the most proximal and distal poles of the coronary sinus (CS) electrodes. Entrainment pacing was performed around the MA, roof area, or cavotricuspid isthmus (CTI) depending on the CSAT result. Mechanisms of tachycardias included macro-reentry around the MA (perimitral atrial flutter [PM-AFL], n=63), roof-dependent AFL (Roof-AFL, n=14), CTI-dependent AFL (CTI-AFL, n=25), and atrial tachycardia (AT, n=26). When the CSAT was ≥45ms, the MA activation sequence was sequential, either proximal to distal or distal to proximal. When the CSAT was <45ms, the MA activation sequence was mainly non-sequential with converging or diverging patterns. CSAT <45ms was highly sensitive in ruling out PM-AFL from other left ATAs. When combined with PPI data from the MA, roof area or CTI, PM-, Roof-, CTI-AFL and AT was successfully differentiated with a high predictive accuracy. Conclusions: A diagnostic algorithm combining CSAT and entrainment pacing is helpful to assess the mechanism of ATAs during catheter ablation of AF. (Circ J 2013; 77: 619–625)