Key result
Contralateral transvenous left ventricular lead placement with pre-sternal tunnelling was successfully performed in 2 patients with blocked ipsilateral subclavian veins, resulting in stable lead parameters and clinical improvement at 1 year.
Case Report (n=2)
No
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Contralateral transvenous left ventricular lead placement with pre-sternal tunnelling is a feasible technique for biventricular upgrade in patients with ipsilateral venous occlusion.
Cardiac resynchronisation therapy (CRT) is a recognised therapy for the management of severe left ventricular dysfunction, advanced congestive cardiac failure (NYHA III or IV), ventricular dyssynchrony (either broad LBBB or mechanical dyssynchrony on echocardiography) and failure of optimal medical therapy to achieve improvement in clinical status. Upgrading right ventricular pacemakers or defibrillators to biventricular devices is common and we describe here, 2 such cases of biventricular upgrade with blocked venous access on the ipsilateral side and successful placement of left ventricular leads following pre-sternal tunnelling from the contralateral side.
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Sadarmin et al. (2015) conducted a case report in Severe left ventricular dysfunction with blocked ipsilateral subclavian veins (n=2). Contralateral transvenous left ventricular lead placement with pre-sternal tunnelling was evaluated on Successful lead placement and clinical improvement. Contralateral transvenous left ventricular lead placement with pre-sternal tunnelling was successfully performed in 2 patients with blocked ipsilateral subclavian veins, resulting in stable lead parameters and clinical improvement at 1 year.
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