Key result
IVUS enables successful coronary vein lead implantation in life-threatening contrast anaphylaxis.
Why the study?
Coronary vein venography with contrast medium is generally contraindicated in patients with severe renal impairment or a history of adverse contrast reactions, complicating CRT lead implantation.
Can intravascular ultrasound guidance be used for successful coronary vein lead implantation in a patient with life-threatening contrast medium anaphylaxis?
Case Report (n=1)
Can intravascular ultrasound guidance be used for successful coronary vein lead implantation in a patient with life-threatening contrast medium anaphylaxis?
Intravascular ultrasound guidance offers a feasible alternative for coronary vein lead implantation during CRT in patients with severe contrast allergy.
Alternative CV venography may aid CRT implantation in complex cases; leaves open need for prospective validation before wider use.
Cardiac resynchronization therapy (CRT) is an effective treatment for patients with symptomatic chronic heart failure (HF), a wide QRS complex, and reduced left ventricular ejection fraction. CRT produces electrical and mechanical resynchronization leading to QRS shortening and left ventricular reverse remodeling.1 CRT has also been shown to improve HF symptoms, reduce HF-associated hospitalization, and lead to a better survival rate. Coronary vein (CV) venography during the CRT device implantation procedure is necessary to evaluate the anatomy of the CV; however, the use of contrast medium for CV lead implantation is generally contraindicated in patients with severely impaired renal function or a medical history of adverse effects to contrast media.
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Kataoka et al. (2020) conducted a case report in Chronic heart failure with contrast medium anaphylaxis (n=1). Intravascular ultrasound guidance was evaluated on Successful coronary vein lead implantation. Intravascular ultrasound guidance allowed for successful coronary vein lead implantation in a patient with life-threatening contrast medium anaphylaxis.
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