"Box CS" , a newly innovated signal adapter to improve locating coronary sinus in current practice.

Abstract

          Some patients with congestive heart failure with reduced left ventricular ejection fraction  less than 35%  were found to have dyssynchrony problem which was recognized as timing of each left ventricular wall contraction occurring at different time. Previous reports found that dyssynchrony of left ventricle contraction may play an important role of worsening heart failure in those patients. Therefore, cardiac resynchronization therapy (CRT) has been performed in these patients based on current guidelines in order to help improve patient’s clinical outcomes of heart failure. In general, operators required to have advance skills and collective experiences to be able to performed CRT placement successfully and timely. When compared to pacemaker or automated implantable cardioverter defibrillator placement procedure, CRT placement likely takes additional time to left ventricular (LV) lead placement. Engagement of coronary sinus ostium in timely fashion is a crucial of initial step of placing LV lead. However, CS ostium engagement can be challenging in some patients. Therefore, our team has innovated a new tool called “BOX CS” to help operator locating CS ostium in timely manner. By using BOX CS to locate CS ostium, we hope to have reduction in procedural time, fluoroscopic time , contrast amount and complication.