{"title":"Challenging coronary sinus lead placement for CRT: A modified \"Anchoring balloon\" technique.","authors":"Ronpichai Chokesuwattanaskul, Nithi Tokavanich, Suphot Srimahachota","doi":"10.1111/pace.14869","DOIUrl":null,"url":null,"abstract":"<p><p>An 80-year-old man with a history of complete heart block underwent dual chamber pacemaker implantation about a year ago. He returned to the hospital due to de novo heart failure caused by pacing-induced cardiomyopathy; hence, we planned to upgrade his pacemaker to a biventricular device. The initial strategy was to perform left bundle branch area pacing-optimized cardiac resynchronization therapy (LOT-CRT) with left bundle branch area pacing (LBBAP) combined with a coronary sinus (CS) lead. In this challenging case, the successful placement of a CS lead was hindered by a complicated combination of a large CS body linked to the left superior vena cava and a winding CS branch. However, utilizing readily available tools, such as the coronary balloon and Guide Plus II ST catheter, proved instrumental in overcoming these obstacles. As a result, LOT-CRT provided the patient with a safe alternative to surgical LV lead placement.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.14869","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
An 80-year-old man with a history of complete heart block underwent dual chamber pacemaker implantation about a year ago. He returned to the hospital due to de novo heart failure caused by pacing-induced cardiomyopathy; hence, we planned to upgrade his pacemaker to a biventricular device. The initial strategy was to perform left bundle branch area pacing-optimized cardiac resynchronization therapy (LOT-CRT) with left bundle branch area pacing (LBBAP) combined with a coronary sinus (CS) lead. In this challenging case, the successful placement of a CS lead was hindered by a complicated combination of a large CS body linked to the left superior vena cava and a winding CS branch. However, utilizing readily available tools, such as the coronary balloon and Guide Plus II ST catheter, proved instrumental in overcoming these obstacles. As a result, LOT-CRT provided the patient with a safe alternative to surgical LV lead placement.
一位有完全性心脏传导阻滞病史的80岁老人大约一年前接受了双腔起搏器植入术。他因起搏诱导的心肌病引起的新发性心力衰竭而返回医院；因此，我们计划将他的起搏器升级为双心室设备。最初的策略是用左束支区域起搏（LBBAP）结合冠状窦（CS）导线进行左束支区起搏优化心脏再同步治疗（LOT-CRT）。在这种具有挑战性的情况下，连接到左上腔静脉的大CS体和缠绕的CS分支的复杂组合阻碍了CS导线的成功放置。然而，使用现成的工具，如冠状动脉球囊和Guide Plus II ST段导管，被证明有助于克服这些障碍。因此，LOT-CRT为患者提供了手术左心室导线放置的安全替代方案。
期刊介绍：
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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