Key result
Firm guidewires cause coronary sinus intima stripping during LV lead implantation.
Firm guidewires and coronary catheters should be avoided within the coronary sinus during left ventricular lead implantation to prevent intimal stripping.
May warrant caution with firm guidewires in the coronary sinus during CRT; leaves open optimal device selection.
Previously, complications associated with the placement of the left ventricular pacing lead were reported in 1.9-6% of cases. We describe a case with a stripping of venous intima from the coronary sinus by a guidewire during a left ventricular lead implantation. Judging from this case, the firm guidewire and coronary catheter should not be used within the coronary sinus.
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Adachi et al. (2007) studied this question. A firm guidewire used during left ventricular lead implantation caused stripping of the coronary sinus venous intima, indicating these devices should not be used within the coronary sinus.
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