Why the study?
Biventricular pacing lead implantations may fail due to anatomical reasons, including the impossibility of coronary sinus cannulation.
Does the snare technique enable successful coronary sinus cannulation in heart failure patients with difficult anatomy during cardiac resynchronization therapy?
Does the snare technique enable successful coronary sinus cannulation in heart failure patients with difficult anatomy during cardiac resynchronization therapy?
The snare technique using a dual approach from the subclavian and femoral veins provides a viable bail-out strategy for difficult coronary sinus cannulation during CRT implantation.
May offer bail-out for difficult CS cannulation in CRT; leaves open need for prospective validation.
PURPOSE: Biventricular pacing is a mainstay of therapy for patients with heart failure. However, lead implantations may fail due to anatomical reasons including the impossibility of coronary sinus cannulation. METHODS AND RESULTS: A dual approach from the subclavian vein using a snare through a sheath and from the femoral vein using a steerable electrophysiology catheter was performed. Once the snare hooked the catheter, the latter was advanced into the coronary sinus and finally, the sheath could also be advanced in an "over-the-wire" technique. CONCLUSION: The snare technique for coronary sinus cannulation offers a "bail-out" strategy for left ventricular lead implantation.
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Höfer et al. (2020) studied this question.
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