Efficacy of minimally invasive left ventricular epicardial lead placement for cardiac resynchronization therapy / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>Ventricular resynchronization might be achieved via minimally invasive left ventricular epicardial lead placement.</p><p><b>METHOD</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>