Europace Advance Access originally published online on August 17, 2007
Europace 2007 9(11):1038-1040; doi:10.1093/europace/eum176
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CARDIAC RESYNCHRONISATION THERAPY
Biventricular ICD implant using endocardial LV lead placement from the left subclavian vein approach and transseptal puncture via the transfemoral route
South West Cardiothoracic Centre, Department of Cardiology, Derriford Hospital, Derriford Road, Plymouth, Devon PL6 8DH, UK
We present the case of a 72 years old diabetic male patient with severe dilated ischaemic cardiomyopathy and New York Heart Association functional class III symptoms and previous unsuccessful attempts to cardiac resynchronization therapy using the conventional epicardial left ventricular (LV) pacing through the coronary sinus. He also had an indication for ICD implantation. We successfully implanted a biventricular ICD system from the standard left subclavian vein approach using endocardial placement of the LV lead via a transfemorally performed transeptal puncture. This technique offered him a suitable alternative to either a thoracoscopic LV lead placement (not routinely performed in our centre) or a high-risk thoracotomy procedure and multisite pacing using epicardial leads.
Key Words: Cardiac resynchronization, implantable cardiac defibrillators, transeptal puncture, endocardial lead placement
* Corresponding author. Tel/fax: +44 156 677 9429. E-mail address: bnuta{at}doctors.org.uk
Manuscript submitted 29 April 2007. Accepted after revision 20 July 2007.
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