Procedure-related Complication
In general, procedure-related complications in CRT implantations are
more frequently observed in female patients with CRT-D, mostly
attributable to pneumothorax, pericardial tamponade, and CS dissection
(15). The incidence rate of CS dissection has been reported as ranging
from 1.4 to 6.8% (15,16), which may be caused by inadequate cannulation
to a CS branch, presence of intravascular obstructions, aggressive
manipulation of a guiding sheath, tortuous vessels, or unusual anatomy
(16). In the current study, procedure-related complications, especially
mechanical injuries of the CS were significantly less in the Inner-Cath
group. The use of Inner-Cath for CS cannulation, especially guided by an
EP catheter, may prevent risk of mechanical injuries of the CS trunk and
tributaries due to the manipulation of guiding catheters.