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Autori principali:	Ramazan Gunduz, Bekir Serhat Yildiz
Natura:	Artículo Open Access
Pubblicazione:	Wiley 2025
Soggetti:	Pacing and Clinical Electrophysiology
Accesso online:	https://onlinelibrary.wiley.com/doi/10.1111/pace.70011
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Successful Implantation of New Coronary Sinus Lead Using Angioplasty for Lead‐Related Vein Occlusion in a CRT‐D Patient Ramazan Gunduz Bekir Serhat Yildiz Pacing and Clinical Electrophysiology Abstract This case is a rare occurrence of atrial and coronary sinus (CS) lead dislocation 5 years post cardiac resynchronization therapy‐defibrillator (CRT‐D) implantation, thus necessitating a unique approach. The previous lead‐related vein occlusion was dilated with a balloon using methods typically employed in coronary procedures to address stenosis at the lateral branch of the CS, followed by insertion of a new lead. Materials and techniques used in coronary artery interventional procedures can also be applied in cases of CS vein branch stenosis encountered during CRT‐D implantation. This case represents one of the rare procedures performed in this manner. 10.1111/pace.70011 http://onlinelibrary.wiley.com/termsAndConditions#vor

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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