Ventricular Resynchronization: A New Technique and Device for Endocardial Left Ventricular Lead Placement

pp 143-146

Abstract

The difficulties regarding the implantation of devices for cardiac resynchronization therapy have generated the necessity to look for alternative pacing techniques, such as endocardial left ventricular lead placement via the transseptal approach from the right atrium. In this sense, several studies have been published in the last years. Although all these studies have reported satisfactory outcomes, they all use “special” techniques with their own limitations, as the procedures should be performed by experienced operators who have overcome the learning curve. This might be the reason why these techniques have not become “popular” yet despite the favorable outcomes reported. The procedure here described intends to establish a methodology based on routine techniques used worldwide in the electrophysiology labs to allow a simple, effective, fast and safe lead placement with a minimum learning curve. The procedure consists in introducing an endocardial lead in the left ventricle through a conventional transfemorally performed transseptal puncture; the lead is then tunneled to the right or left subclavian vein and the implant is completed in the conventional fashion.