Implantation of Active Fixation Leads in Coronary Veins for Left Ventricular Stimulation: Report of Five Cases
- 1 January 2007
- journal article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 30 (1), 44-49
- https://doi.org/10.1111/j.1540-8159.2007.00578.x
Abstract
Securing transvenous left ventricular (LV) pacing leads without an active fixation mechanism in proximal coronary vein (CV) segments is usually challenging and frequently impossible. We investigated how active fixation leads can be safely implanted in this location, how to avoid perforating the free wall of the CV, and how to recognize and respond to perforations. In five patients with no alternative to LV pacing from proximal CV segments, 4 Fr SelectSecure (Medtronic, Minneapolis, MN, USA) leads, which have a fixed helix, were implanted through a modified 6 Fr guide catheter with a pre-shaped tip (Launcher, Medtronic). Active fixation leads were successfully implanted in proximal CVs in five patients. There were no complications. Acute and chronic pacing thresholds were comparable to those of conventional CV leads. The pre-shaped guide catheter tip remains in close proximity to the myocardial aspect of the CV, directing the lead helix toward a safe implantation site. If only proximal CV pacing sites are available, 4 Fr SelectSecure leads can be safely implanted through a modified Launcher guide catheter, avoiding more invasive implantation techniques. Other than venous stenting or implantation of leads with retractable tines, SelectSecure leads are expected to remain extractable.Keywords
This publication has 20 references indexed in Scilit:
- Linksventrikuläre Stimulation und CRTHerzschrittmachertherapie + Elektrophysiologie, 2006
- Cardiac Resynchronization—A Heart Failure PerspectiveAnnals of Noninvasive Electrocardiology, 2005
- Effekt der Cardialen Resynchronisationstherapie (CRT) auf die Belastbarkeit und Lebensqualität bei HerzinsuffizienzpatientenHerzschrittmachertherapie + Elektrophysiologie, 2005
- Kardiale Resynchronisationstherapie und ArrhythmienHerzschrittmachertherapie + Elektrophysiologie, 2005
- Effekt von CRT auf Morbidit t und Mortalit tHerzschrittmachertherapie + Elektrophysiologie, 2005
- Aktuelle LeitlinienHerzschrittmachertherapie + Elektrophysiologie, 2005
- Kardiale Resynchronisationstherapie—aktueller Stand und zukünftige PerspektivenHerz, 2003
- The promise of resynchronization therapy. Who (and how many) will benefit?Cardiac Electrophysiology Review, 2003
- Cardiac Resynchronization in Chronic Heart FailureNew England Journal of Medicine, 2002
- Left Heart Pacing—Experience with Several Types of Coronary Vein LeadsJournal of Interventional Cardiac Electrophysiology, 2002