[Efficacy of minimally invasive left ventricular epicardial lead placement for cardiac resynchronization therapy].

ABSTRACT

OBJECTIVE: Ventricular resynchronization might be achieved via minimally invasive left ventricular epicardial lead placement. METHOD: Six patients with congestive heart failure underwent minimally invasive left ventricular epicardial lead placement after failed coronary sinus cannulation were followed up for 1 year, cardiac function and LV lead threshold were evaluated. RESULTS: There were no in-hospital deaths, intraoperative complications and diaphragm stimulation. Correct lead positioning was achieved in all 6 patients. LV lead thresholds remained unchanged [(1.2 ± 0.5) V vs (1.1 ± 0.4) V, P = 0.68] at 12 months follow-up. Improvements on 6 min walking test [(327 ± 77) m vs (267 ± 68) m, P = 0.001], LVEF [(26.1 ± 6.0)% vs (38.2 ± 4.7)%, P = 0.004], and NYHA functional class were evidenced at 12 months follow-up. CONCLUSION: Minimally invasive left ventricular epicardial lead placement is a safe and reliable technique and should be considered as an alternative option in case of difficult coronary venous anatomy and inability to position the lead for resynchronization therapy.