Exploring a New Systematic Route for Left Ventricular Pacing in Cardiac Resynchronization Therapy
Frédéric Anselme1, Mohammad Albatat2, Christelle Marquié3
1Rouen University Hospital.
Summary
Left ventricular venous collaterals are consistently present in cardiac resynchronization therapy patients. This vascular network facilitates the implantation of new ultra-thin microleads for improved CRT delivery.
Area of Science:
- Cardiovascular Research
- Medical Device Technology
- Interventional Cardiology
Background:
- Assessing left ventricular (LV) venous collaterals in vivo.
- Evaluating the feasibility of a new ultra-thin LV quadripolar microlead for cardiac resynchronization therapy (CRT).
Purpose of the Study:
- To determine the frequency and distribution of LV venous collaterals.
- To assess the ease and feasibility of implanting a novel LV microlead for CRT.
Main Methods:
- Analysis of venograms from retrospective (2008-2012) and prospective (2018) CRT patients.
- Identification of venous collaterals (>0.5 mm diameter) between LV segments and major LV veins.
- Attempted LV microlead implantation in prospective patients with evaluable venograms.
Main Results:
- Venous collaterals were present in all CRT patients with evaluable venograms (36/36).
- Highest collateral prevalence was between apical inferior/lateral (42%) and mid inferior/inferolateral (42%) segments.
- Most prevalent collateral connections were between the inferior interventricular vein (IIV) and lateral vein (64%) and IIV and infero-lateral vein (36%).
- LV microlead implantation was successful in 90% (18/20) of attempted cases.
Conclusions:
- In vivo LV venous collaterals are consistently found in CRT patients.
- This collateral network provides a viable route for accessing multiple LV sites with a single microlead.
- The findings support the use of this network for novel CRT device implantation.
Keywords:
Cardiac resynchronization therapyCoronary sinus angiogramLeft ventricular leadMultisite pacingVenous collateralMore Related Videos
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