Related Experiment Video
Updated: Jul 13, 2026
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
The use of telescoping guide catheters for coronary sinus cannulation and sub-selecting tributaries in left
Jürgen Vogt1, Torsten Schwarz, Daniel Gras
1Heart Center North Rhine Westphalia, Bad Oeynhausen, Germany.
Insights
A new adaptable, dual telescoping catheter system significantly improves coronary sinus cannulation success rates for cardiac resynchronization therapy lead implants. This adjustable system enhances lead placement in challenging patient anatomies.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Coronary sinus (CS) cannulation for left ventricle (LV) lead placement in cardiac resynchronization therapy (CRT) is technically challenging.
- Current methods often require catheter exchanges, increasing procedure time and complexity.
Purpose of the Study:
- To evaluate the efficacy of a novel dual telescoping catheter system for CS cannulation in CRT patients.
- To compare the success rates of adaptable telescoping catheters versus fixed-shape catheters.
Main Methods:
- A prospective study involving 64 patients undergoing CRT device implantation.
- Randomized testing of five different catheter designs, including adaptable telescoping systems and a fixed-shape catheter, for CS cannulation.
- Evaluation of cannulation success rates based on catheter design and CS ostium visibility.
Main Results:
- Adaptable telescoping catheters demonstrated higher overall CS cannulation success rates (62-68%) compared to fixed-shape catheters (46%).
- Success rates were notably higher with adaptable catheters when the CS ostium location was unknown (53-72% vs. 33%).
- A second group showed high success rates (71-80%) with telescoping catheters, irrespective of inner catheter use.
Conclusions:
- The adjustable dual telescoping catheter system offers adaptability to diverse patient anatomies, improving CS cannulation success.
- The system's adjustability in the right atrium facilitates ostium identification and cannulation.
- The inner catheter enables precise sub-selection of CS tributaries for lead placement.
Introduction:
Failure to enter the coronary sinus (CS) with a guiding catheter and entering its tributaries remains challenging in left ventricle (LV) pacing lead implants for cardiac resynchronization therapy (CRT). A dual telescoping catheter system (8F outer/6F inner) is designed to provide the ability to adjust the catheter curve size, shape and/or reach to the patients' anatomy avoiding the need for catheter change.
Methods:
Five different designs for CS cannulation were randomly tested in 64 patients scheduled for CRT device implant.
Results:
In 33 consecutive patients three adaptable telescoping guiding catheter systems were tested per patient, the adaptable catheters had higher overall cannulation success rates (68, 63 and 62%) compared to the fixed shape catheter (46%) and an greater cannulation success rate when the CS location was not known (70, 53 and 72% vs 33% for the fixed shape). In a second group of 31 CRT patients the two telescoping catheters had similar high levels of success (71-80%), with or without using the inner catheter.
Conclusions:
The telescopic system is adaptable to a wide range of anatomical variations in patients and can result in a higher CS cannulation success rate due to its adjustability in the RA in search for the CS ostium. On top of this the inner catheter allows for sub-selecting the CS tributaries.
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
01:21Cardiac Catheterization II: Right Heart Catheterization
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:26Cardiac Catheterization IV: Nursing Management