PREDICTION OF FAILED PACEMAKER IMPLANTATION VIA CEPHALIC VEIN APPROACH BY PRE-PROCEDURE DUPLEX ULTRASONOGRAPHY OF CEPHALIC VEIN JAN-YOW CHEN, KUAN-CHENG CHANG, YU-CHIN LIN, HSIANG-TAI CHOU, JUI-SUNG HUNG Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan Introduction: Cephalic vein approach for pacemaker implantation is an important and well-established route. However, there is still a significant incidence of failed implantation procedure (10-36%). Cephalic vein abnormality was considered to contribute the failed procedure. We propose that pre-procedure duplex ultrasonography of the proximal cephalic vein is valuable to predict the cephalic vein abnormality and therefore predict the failed procedure. Methods: We enrolled 36 consecutive patients undergoing new pacemaker implantation and performed duplex ultrasonography to assess the cephalic vein before implantation. The cephalic vein diameter, patency and morphology were evaluated and recorded by duplex ultrasonography before procedure. At least 1 endocardial lead was implanted using a cephalic vein approach was defined as a successful procedure. Results: Seven patients (19.2%) were failed in the implantation procedure. Two patients failed in the cephalic vein isolation. The ultrasonography imaging showed a small diameter (1.8 mm) in one and abnormal insertion site of proximal cephalic vein in the other patient. Two patients failed in navigation of the guide-wire to the axillary vein. Significant tortuous ultrasonographic morphology was found in the ultrasonographic imaging. Three patients failed in guide-wire cannulation into the cephalic vein. In the 3 patients, the pre-procedure duplex ultrasonography showed relative smaller diameters than the other patients (3.4 ? 1.4 mm vs. 1.7 ? 0.3 mm, P < 0.05). Conclusions: Pre-procedure duplex ultrasonography helps in prediction of cephalic vein abnormality and subsequently benefits the prediction of failed de?
關聯:
The 3rd international congress on cardiovascular disease
