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Optimale Elektrodenposition

Was ist bei der Implantation biventrikulärer Schrittmacher zu beachten?

Optimal electrode placement

What to consider during implantation of a biventricular pacemaker?

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Die transvenöse Implantation von linksventrikulären Elektroden zur kardialen Resynchronisationstherapie hat seit Entwicklung der ersten Koronarsinuselektroden vor fast 10 Jahren einen fulminanten Siegeszug angetreten und inzwischen als Standardmethode alle anderen Verfahren abgelöst. Für jeden einzelnen der geschilderten Schritte der Implantation gibt es inzwischen firmenübergreifend ein großes Sortiment an Werkzeugen, das dem erfahrenen Implanteur erlaubt der Anatomie entsprechend auszuwählen und somit eine Erfolgsquote von 95–98% zu erzielen. Neben dem Einschätzen der anatomischen Situation und dem Vorhalten der vielfältigen Werkzeuge entscheiden letztlich nicht selten der unbedingte Wille und die Hartnäckigkeit über Implantationserfolg oder Versagen.

Abstract

Since the introduction of transvenous left ventricular lead systems nearly a decade ago, resynchronization therapy has gained widespread acceptance and has become a growing field in heart failure therapy. Due to the increasing numbers of implanting centers and physicians, the need for adequate education is increasing. This article describes and illustrates the anatomical background, the technical opportunities and pitfalls, which have to be overcome, to achieve an implanting success rate of 95% to 98%, as can be achieved by well-trained physicians under optimal conditions.

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Authors and Affiliations

  1. Abteilung für Kardiologie, Herzzentrum Brandenburg in Bernau und Evangelisch Freikirchliches Krankenhaus, Ladeburger Str. 17, 16321, Bernau bei Berlin, Deutschland

    C. Butter

  2. Abt. für Innere Medizin, Oberhavelkliniken Hennigsdorf, Hennigsdorf, Deutschland

    H.-H. Minden

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  2. H.-H. Minden
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Correspondence to C. Butter.

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Butter, C., Minden, HH. Optimale Elektrodenposition. Herzschr. Elektrophys. 20, 109–120 (2009). https://doi.org/10.1007/s00399-009-0051-8

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  • DOI: https://doi.org/10.1007/s00399-009-0051-8

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