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Related Experiment Videos

A method for permanent transvenous left ventricular pacing

J J Blanc1, D G Benditt, M Gilard

  • 1Department of Cardiology, Brest University-Hospital, France.

Pacing and Clinical Electrophysiology : PACE
|November 25, 1998
PubMed
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A new "long guiding sheath" technique simplifies transvenous left ventricular (LV) pacing for severe heart failure patients with left bundle branch block. This method improves procedural success and reduces time compared to traditional approaches.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Left ventricular (LV) pacing shows promise for severe cardiac failure and left bundle branch block (LBBB).
  • Traditional epicardial lead placement for LV pacing carries excessive surgical mortality.
  • Transvenous LV pacing is preferred but technically challenging due to coronary sinus cannulation difficulties.

Purpose of the Study:

  • To describe and evaluate a novel "long guiding sheath" method for transvenous LV permanent pacing.
  • To assess the feasibility, success rate, and procedural time of this new technique.

Main Methods:

  • A "long guiding sheath" technique involving catheterization and a long, radiopaque, peelable sheath was developed.
  • The sheath was advanced into the coronary sinus after initial catheterization.

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  • A permanent pacing electrode was then inserted through the sheath into a coronary sinus tributary.

    • Main Results:

    • The "long guiding sheath" method was attempted in 10 patients.
    • Successful LV lead placement was achieved in 8 out of 10 patients.
    • Average lead insertion time was 21 +/- 5.5 minutes, and average fluoroscopic time was 11 +/- 5.5 minutes.

    Conclusions:

    • Transvenous left ventricular pacing remains technically demanding.
    • The "long guiding sheath" approach significantly facilitates the procedure.
    • This method offers a high success rate and acceptable procedural times for LV pacing.