Coronary sinus for cardiac resynchronization therapy: leave it alone and go for the branch! a case report

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Percutaneous coronary sinus interventions are increasing, limiting conventional cardiac resynchronization therapy (CRT) options.
• Alternative CRT approaches are necessary for patients with contraindications to standard CRT.

Observation:

• A case of successful CRT using direct left bundle branch permanent pacing (LBBP) is presented.
• The patient had a relative contraindication to conventional CRT due to prior percutaneous indirect mitral annuloplasty.

Findings:

• Left bundle branch permanent pacing (LBBP) is an emerging, promising technique for physiological cardiac pacing and CRT.
• LBBP can be the preferred method when the coronary sinus is not viable for conventional left ventricular lead implantation.

Implications:

• LBBP provides a viable alternative for CRT in complex patient cases.
• This technique expands the possibilities for achieving CRT when traditional approaches fail or are contraindicated.