The "Block the Main Way" Technique for Left Ventricular Lead Implantation in Cardiac Resynchronization Therapy: A...

This case details the successful application of the Block the Main Way (BMW) technique to implant a left ventricular (LV) lead into an anomalously opening lateral vein during Left Bundle Branch-Optimized Cardiac Resynchronization Therapy Defibrillator (LOT-CRTD) implantation.We innovatively deployed a balloon to occlude the distal great cardiac vein adjacent to the target vessel ostium. This approach created a unidirectional pathway that provided both route guidance and enhanced support for LV lead wire manipulation, thereby reducing procedural complexity and shortening operation time. In clinical practice, the BMW technique has significantly improved LV lead implantation success rates by minimizing intravascular manipulations, reducing potential vascular injury risks, and markedly decreasing procedural duration.