Repetitive intraoperative dislocation during transvenous left ventricular lead implantation: usefulness of the retained guidewire technique

Dislocation of the transvenous left ventricular lead has been reported in a substantial number of patients selected for cardiac resynchronization therapy. We describe a novel technique using a retained guidewire in patients with repetitive intraoperative dislocation to stabilize the lead in its final position. Pacing and sensing parameters between patients in whom the retained guidewire technique was used (n = 6) were not significantly different as compared to the group of patients (n = 67) without this technique during a 6-month follow-up. No dislocations were observed in the group of patients with the retained guidewire technique and fluoroscopic evaluation did not reveal (minor) dislocation. This technique might be considered for patients with repetitive intraoperative left ventricular lead dislocation.