Why the study?
Does a collateral route for left ventricular lead implantation provide stable lead position in a patient with abnormal venous anatomy?
Does a collateral route for left ventricular lead implantation provide stable lead position in a patient with abnormal venous anatomy?
Using a collateral route for left ventricular lead implantation is a feasible new technique for patients with abnormal venous anatomy undergoing cardiac resynchronization therapy.
May offer alternative LV lead access in complex venous anatomy; leaves open broader CRT applicability pending prospective data.
A 75-year-old man, 8 years after CABG, with ischemic cardiomyopathy underwent cardiac resynchronization therapy (CRT) for refractory heart failure. Retrograde occlusion venography revealed absence of lateral vein. A functionally occluded middle cardiac vein with branch to anterolateral vein was used for left ventricular lead implantation. Using a collateral route for left ventricular lead implantation is a new technique. Lead position was stable with excellent threshold. Follow-up at 6 months reveals continued stable lead position.
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Bali et al. (2013) studied this question.
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