| 摘要 |
A method of ultrasonic guidance of the aiming and steering of the pacing lead into the coronary vein via the coronary sinus (CS) is disclosed. The aim is to place a pacing electrode into the left coronary vein enabling left heart pacing with or without concurrent right heart pacing. The placement may be done via the coronary sinus. The procedure must include visualization of the coronary sinus, preferably by ultrasound scanning, localization of the pacing catheter tip, directing - steering the tip along the CS axis and thus its placement into the coronary sinus. A marking piezoelectric transducer is mounted at or near the tip of the steerable delivery catheter that we want to localize in the vicinity of the coronary sinus. When this piezoelectric transducer comes within the scanning plane of an ultrasonic scanner, the pulses transmitted by it hit the said marker transducer. Such signals can in different ways be used for generation of visible guiding marks on the scanner screen. A representative method of such application is the use of a transponder connected to the said ultrasonic transducer. Additionally an ultrasonically marked wire, comprising an ultrasonic transducer at its tip may be implanted into the left ventricular venous system through said catheter. The wire is used to guide the pacing electrode, which is slid over the wire into the coronary vein. In this case a second transponder is used to ultrasonically control the placement of the guide wire into the left coronary vein system. |
