Key result
Balloon-assisted tracking technique successfully facilitated left ventricular lead implantation by overcoming a competent vein valve, leading to clinical improvement at 9 months.
Why the study?
Competent lateral and posterolateral valves with proximal tortuosity may hinder left ventricular lead implantation during cardiac resynchronization therapy.
Does the balloon-assisted tracking technique facilitate left ventricular lead implantation in patients with competent coronary sinus valves and proximal tortuosity?
Case Report (n=1)
Does the balloon-assisted tracking technique facilitate left ventricular lead implantation in patients with competent coronary sinus valves and proximal tortuosity?
The balloon-assisted tracking technique is a feasible method to overcome competent coronary sinus valves and venous tortuosity during left ventricular lead implantation for cardiac resynchronization therapy.
BACKGROUND: Competent lateral and posterolateral valves showed proximal tortuosity that might hinder left ventricular (LV) lead implantation in cardiac resynchronization therapy (CRT). CASE SUMMARY: A 57-year-old woman was diagnosed as non-ischaemic cardiomyopathy, no other comorbidities, complaining of dyspnoea [New York Heart Association (NYHA) class III], and on optimal medical therapy. Electrocardiogram showed left bundle branch block with QRS duration 150 ms. The patient was candidate for CRT. However, during LV lead implantation, a competent posterolateral vein valve and proximal tortuosity hindered LV lead implantation that was overcome by balloon-assisted tracking technique. At 9 months of follow-up, the patient had NYHA class II, ejection fraction improved to 38%, and all implanted leads were still in place. DISCUSSION: Balloon-assisted tracking technique can be used to cross coronary sinus and smaller veins with competent valves and coronary veins tortuosity.
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Samy et al. (2022) conducted a case report in Non-ischaemic cardiomyopathy (n=1). Balloon-assisted tracking technique was evaluated on Successful left ventricular lead implantation and clinical improvement. Balloon-assisted tracking technique successfully facilitated left ventricular lead implantation by overcoming a competent vein valve, leading to clinical improvement at 9 months.
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