Targeted left ventricular endocardial pacing using a steerable introducing guide catheter and active fixation pacing...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Cardiac resynchronization therapy (CRT) is crucial for heart failure management.
• Coronary sinus (CS) lead placement is the standard for CRT, but not always feasible.
• Left ventricular (LV) endocardial pacing presents an alternative approach.

Purpose of the Study:

• To evaluate the feasibility of LV endocardial pacing.
• To assess the use of a steerable lead introducer and active fixation polyurethane lead for this procedure.

Main Methods:

• Attempted LV endocardial lead placement in nine patients with prior failed CS lead placement.
• Utilized trans-septal puncture and a steerable introducer catheter.
• Implanted active fixation polyurethane leads in the LV endocardium.

Main Results:

• Successful LV lead placement was achieved in eight out of nine patients.
• No acute complications or embolic events occurred during follow-up (1-32 months).
• All implanted patients showed symptomatic improvement or maintenance of benefits.

Conclusions:

• LV endocardial pacing is a feasible alternative to CS pacing.
• Further trials are warranted to determine long-term benefits and risks.