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Cardiac Catheterization III: Left Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...

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Updated: May 25, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Thoracoscopic left ventricular lead implantation.

Marek Pojar¹, Jan Vojacek, Miloslav Tauchman

¹Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic. marek.pojar@centrum.cz

Acta Cardiologica

|February 4, 2012

Summary

Minimally invasive thoracoscopic surgery offers a safe alternative for left ventricular lead implantation in heart failure patients when traditional methods fail. This approach demonstrates excellent acute capture, improving treatment options.

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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

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Published on: August 8, 2025

Area of Science:

Cardiology
Thoracic Surgery
Medical Devices

Background:

Cardiac resynchronization therapy (CRT) is vital for managing chronic heart failure.
Epicardial lead implantation is a secondary option for biventricular pacing after failed coronary sinus cannulation.
Minimally invasive techniques are emerging for complex cardiac procedures.

Purpose of the Study:

To evaluate the initial experience and safety of minimally invasive surgical lead implantation using thoracoscopy for CRT.
To assess the feasibility of epimyocardial lead placement in patients with prior failed endocardial lead attempts.

Main Methods:

A cohort of 17 heart failure patients (NYHA class III, low ejection fraction) underwent thoracoscopic left ventricular lead implantation.
Epimyocardial steroid-eluting screw-in leads were placed on the left ventricular free wall under single-lung ventilation.
Video-assisted thoracoscopy guided the lead placement procedure.

Main Results:

No in-hospital deaths or major complications were reported.
Mean operative time was 115.9 minutes, with an average hospital stay of 8.4 days.
Excellent acute left ventricular lead capture (0.88 V/0.5 ms) and lead impedance (434.7 Omega) were achieved.

Conclusions:

Minimally invasive thoracoscopic left ventricular lead implantation is a safe and effective procedure.
The technique provides excellent acute electrical parameters, supporting its use in selected CRT patients.
This approach expands therapeutic options for heart failure patients requiring biventricular pacing.