Biventricular ICD implantation using endocardial LV lead placement via transfemoral transseptal puncture was successfully performed as an alternative to high-risk thoracotomy in a 72-year-old male.
Case Report (n=1)
No
Does endocardial LV lead placement via transseptal puncture allow successful biventricular ICD implantation in a patient with failed conventional epicardial LV pacing?
Endocardial LV lead placement via transseptal puncture offers a viable alternative for biventricular ICD implantation when conventional coronary sinus approaches fail.
We present the case of a 72 years old diabetic male patient with severe dilated ischaemic cardiomyopathy and New York Heart Association functional class III symptoms and previous unsuccessful attempts to cardiac resynchronization therapy using the conventional epicardial left ventricular (LV) pacing through the coronary sinus. He also had an indication for ICD implantation. We successfully implanted a biventricular ICD system from the standard left subclavian vein approach using endocardial placement of the LV lead via a transfemorally performed transeptal puncture. This technique offered him a suitable alternative to either a thoracoscopic LV lead placement (not routinely performed in our centre) or a high-risk thoracotomy procedure and multisite pacing using epicardial leads.
Nuta et al. (Fri,) conducted a case report in Severe dilated ischaemic cardiomyopathy (n=1). Biventricular ICD implant using endocardial LV lead placement via transfemoral transseptal puncture was evaluated. Biventricular ICD implantation using endocardial LV lead placement via transfemoral transseptal puncture was successfully performed as an alternative to high-risk thoracotomy in a 72-year-old male.