[From guiding catheter to coronary sinus lead]

Area of Science:

• Cardiovascular Medicine
• Medical Devices
• Interventional Cardiology

Context:

• Biventricular pacing system implantation presents significant procedural challenges.
• The transvenous approach via coronary sinus (CS) tributaries is the primary method for initiating left ventricular pacing.
• Existing literature lacks a consolidated overview of current techniques and technological advancements.

Purpose:

• To describe current techniques for achieving coronary sinus access for left ventricular lead placement.
• To present novel developments in guiding catheter and left ventricular lead technology.
• To report on the most frequent complications associated with biventricular pacing system implantation.

Summary:

• This review details transvenous strategies for left ventricular pacing through the coronary sinus.
• It explores advancements in specialized catheters and leads designed for this complex procedure.
• Common procedural complications are identified and discussed.

Impact:

• Provides clinicians with an updated overview of left ventricular lead implantation techniques.
• Highlights emerging technologies that may improve procedural success and patient outcomes.
• Aids in anticipating and managing potential complications, enhancing patient safety in biventricular pacing.