Cardiac Resynchronization Therapy in Difficult Coronary Sinus Anatomy: Left Ventricular Endocardial Approach.

ABSTRACT:

Objective

To achieve cardiac resynchronization in a patient with severe ischemic cardiomyopathy with non-negotiable coronary sinus ostium.

Key steps

A 260-cm coated 0.035-inch wire was advanced into the descending thoracic aorta through the left atrium and left ventricle after trans-septal puncture from the femoral venous route, which was then snared out through the right femoral artery. The other end of the wire was snared out from the left subclavian vein. A sheath with dilator was advanced over this wire to the left ventricular free wall. A thin, lumenless bipolar pacing lead was advanced through the sheath, implanted into the left ventricular lateral wall, and connected to the pulse generator.

Potential pitfalls

The risk of thromboembolism and worsening mitral reg

SUBMITTER: Das A 

PROVIDER: S-EPMC12861678 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature