Targeted left ventricular endocardial pacing using a steerable introducing guide catheter and active fixation pacing lead
Targeted left ventricular endocardial pacing using a steerable introducing guide catheter and active fixation pacing lead
Aims Cardiac resynchronization therapy via the coronary sinus (CS) is not always possible. Left ventricular (LV) endocardial lead placement is a potential alternative. The purpose of this study was to assess the feasibility of endocardial LV pacing using a steerable lead introducer and active fixation polyurethane lead.
Methods and results Endocardial LV lead placement was attempted in nine patients (seven males, age 48–77 years) in whom transvenous CS lead placement had failed. Trans-septal puncture and septal dilatation were performed via the femoral route. A steerable introducer catheter was advanced across the septal puncture site from the right or left subclavian vein into the LV. An active fixation polyurethane lead was then implanted into the high postero-lateral aspect of the LV endocardial wall. All patients were anticoagulated following implant. Successful LV lead placement was achieved in eight patients. There were no acute complications and no embolic events during follow-up (1–32 months). All implanted patients responded well with either improvement in New York Heart Association class or maintenance of symptomatic improvement that had previously been conferred by LV epicardial pacing.
Conclusion Targeted LV endocardial pacing is a potential alternative to CS pacing and warrants a trial to characterize long-term benefits and risks.
502-506
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Scott, Paul A.
5a16b1f4-74d3-473f-9eeb-c2a823d690dc
Turner, Nicholas G.
8d9c8ecf-730c-4974-9c7a-88ceff007080
Yue, Arthur M.
4040f8ec-0252-49e0-b838-58f37956acd2
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
2009
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Scott, Paul A.
5a16b1f4-74d3-473f-9eeb-c2a823d690dc
Turner, Nicholas G.
8d9c8ecf-730c-4974-9c7a-88ceff007080
Yue, Arthur M.
4040f8ec-0252-49e0-b838-58f37956acd2
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Morgan, John M., Scott, Paul A., Turner, Nicholas G., Yue, Arthur M. and Roberts, Paul R.
(2009)
Targeted left ventricular endocardial pacing using a steerable introducing guide catheter and active fixation pacing lead.
Europace, 11 (4), .
(doi:10.1093/europace/eup048).
Abstract
Aims Cardiac resynchronization therapy via the coronary sinus (CS) is not always possible. Left ventricular (LV) endocardial lead placement is a potential alternative. The purpose of this study was to assess the feasibility of endocardial LV pacing using a steerable lead introducer and active fixation polyurethane lead.
Methods and results Endocardial LV lead placement was attempted in nine patients (seven males, age 48–77 years) in whom transvenous CS lead placement had failed. Trans-septal puncture and septal dilatation were performed via the femoral route. A steerable introducer catheter was advanced across the septal puncture site from the right or left subclavian vein into the LV. An active fixation polyurethane lead was then implanted into the high postero-lateral aspect of the LV endocardial wall. All patients were anticoagulated following implant. Successful LV lead placement was achieved in eight patients. There were no acute complications and no embolic events during follow-up (1–32 months). All implanted patients responded well with either improvement in New York Heart Association class or maintenance of symptomatic improvement that had previously been conferred by LV epicardial pacing.
Conclusion Targeted LV endocardial pacing is a potential alternative to CS pacing and warrants a trial to characterize long-term benefits and risks.
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Published date: 2009
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Local EPrints ID: 72857
URI: http://eprints.soton.ac.uk/id/eprint/72857
ISSN: 1099-5129
PURE UUID: b530caa5-3f61-4a0d-a4f5-692a29d1267d
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Date deposited: 24 Feb 2010
Last modified: 13 Mar 2024 21:42
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Author:
John M. Morgan
Author:
Paul A. Scott
Author:
Nicholas G. Turner
Author:
Arthur M. Yue
Author:
Paul R. Roberts
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