Key result
Left ventricular lead implantation via the coronary venous approach for cardiac resynchronisation therapy achieves implant success rates of >95% in experienced hands.
Why the study?
The highly variable anatomy of the coronary venous system can cause difficulties when implanting left ventricular pacing leads for cardiac resynchronisation therapy, requiring strategies to address potential problems and pitfalls.
Examines procedural hurdles in transvenous left ventricular lead placement, highlighting anatomical factors and solutions that enable high success in cardiac resynchronisation therapy.
Cardiac resynchronisation therapy usually requires implantation of a left ventricular lead.The coronary venous approach is nowadays preferred for this purpose because of the less invasive nature compared to direct epicardial stimulation.Optimal hemodynamic support, accessibility of the desired vein location and adequate pacing parameters without phrenic nerve stimulation are the three most important aspects for successful left ventricular lead implantation.The highly variable anatomy of the coronary venous system can sometimes cause difficulties but in experienced hands, implant success rates of more than 95% can be achieved.In this article, the potential problems and pitfalls in implanting left ventricular leads and potential solutions to problematic cases are discussed.
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C STELLBRINK (2004) conducted a review in Patients undergoing cardiac resynchronisation therapy. Left ventricular pacing lead implantation via coronary venous approach vs. Direct epicardial stimulation was evaluated on Implant success rate. Left ventricular lead implantation via the coronary venous approach for cardiac resynchronisation therapy achieves implant success rates of >95% in experienced hands.
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