Key result
Retrograde LV CRT-D lead implantation following lateral vein balloon angioplasty achieves successful positioning and pacing.
Case Report (n=1)
Retrograde approach following lateral vein balloon angioplasty can be a successful technique for left ventricular lead implantation during CRT-D upgrade when standard advancement is difficult.
May succeed when antegrade LV lead placement fails in CRT-D upgrades; leaves open safety and durability in larger cohorts.
A 60-year-old female with heart failure with reduced left ventricle ejection fraction, implantable cardiac defibrillator and left bundle branch block was admitted to Department of Cardiology for cardiac resynchronization therapy defibrillator upgrade. Due to difficulties with advancement of left ventricular lead to lateral coronary vein, balloon angioplasty with use of retrograde approach via collateral branches and two CS sheaths positioning was performed. Final position of lead in lateral vein was achieved resulting with pacing threshold of 0.7 V/0.5 ms, impedance of 720 Ω and QRS of 130 ms.
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Ciechański et al. (2023) conducted a case report in Heart failure with reduced left ventricle ejection fraction, implantable cardiac defibrillator, and left bundle branch block (n=1). Left ventricular CRT-D lead implantation using retrograde approach following lateral vein balloon angioplasty was evaluated on Successful lead positioning and pacing parameters (pacing threshold, impedance, QRS duration). Left ventricular CRT-D lead implantation using a retrograde approach following lateral vein balloon angioplasty achieved a final pacing threshold of 0.7 V/0.5 ms, impedance of 720 Ω, and QRS of 130 ms.
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