First experience with a new active fixation coronary sinus lead

Nägele, Herbert; Azizi, M.; Hashagen, S.; Castel, María Ángeles; Behrens, S.

doi:10.1093/europace/eum061

Cited by 44 publications

(36 citation statements)

References 30 publications

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“…Another factor to consider is the risk associated with active fixation left ventricular lead removal after long-term implantation, should it become necessary. 6) The potential complications of left ventricular pacing via the coronary sinus must be considered in comparison to a further major surgical procedure and its associated risks. In the case we describe, a third surgical procedure would have involved substantial risks and increased morbidity, so ventricular pacing via a branch of the coronary sinus was the preferred approach.…”

Section: Discussionmentioning

confidence: 99%

Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

Swampillai

Heald

Devlin

et al. 2011

Journal of Arrhythmia

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Implantation of a transvenous endocardial pacing lead in the right ventricle is contraindicated after mechanical tricuspid valve replacement; therefore a surgical approach to the epicardium is usually required. This case report describes ventricular pacing via a branch of the coronary sinus in a patient with mechanical mitral, aortic and tricuspid valve replacements. In conclusion, this approach is minimally invasive, provides effective ventricular stimulation with low pacing threshold and stable lead position, and is a feasible option when transvenous right ventricular pacing is not possible. (J Arrhythmia 2011; 27: 343-346)

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Section: Discussionmentioning

confidence: 99%

Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

Swampillai

Heald

Devlin

et al. 2011

Journal of Arrhythmia

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“…Details of the implant procedure have been described elsewhere. 1 The distance between the RV and the active fixation LV lead now equals more than 90% of the total cardiac antero-posterior diameter ( Figure 1). The patient immediately felt better and has since an uneventful course in NYHA class I for more than 1 year.…”

Section: Case Reportmentioning

confidence: 99%

Reversing cardiac resynchronization therapy non-responder status in a patient with a surgically placed epicardial left ventricular lead by switching to an active fixation coronary sinus lead

2008

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puncture. Both the patients improved haemodynamically after the activation of IABP, and the implantations were successfully completed other than the epicardially implanted LV lead in Case 1. No other procedure-related complications were observed.In conclusion, activation of IABP may be a safe and beneficial option for completing the procedure in patients experiencing acute heart failure worsening during CRT implantation. This approach could eliminate both the need for re-operation and diminish the associated risks. Reversing cardiac resynchronization therapy non-responder status in a patient with a surgically placed epicardial left ventricular lead by switching to an active fixation coronary sinus lead This report describes the reversal of a cardiac resynchronization therapy non-responder status in a patient with a surgically placed left ventricular lead by the use of a newly available active fixation coronary sinus lead. Case reportWe report on a 55-year-old man with dilated cardiomyopathy. His left ventricular ejection fraction (LVEF) was 18% at the first presentation. He was in New York Heart Association (NYHA) stage III, despite of optimized medical therapy. Heart transplantation was considered as an option, but the patient also showed a complete left bundle brunch block. Therefore, he received a cardiac resynchronization therapy (CRT) defibrillator system in June 2006. Two dislocations of the coronary sinus (CS) lead occurred and, finally, a surgical approach was chosen. An epicardial (EPI) left ventricular (LV) lead was placed via left lateral thoracotomy. As the patient's condition did not improve (NYHA class III, brain natriuretic peptide (BNP) levels 3800 pg/mL, and LVEF 15%) during the next months, he was admitted for further evaluation. The pacemaker check revealed normal sensing and pacing thresholds, and his electrocardiogram appeared to show biventricular pacing with a reduction in the QRS width by 30 ms. Tissue Doppler imaging revealed the presence of asynchrony, despite formal correct biventricular pacing.

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“…Coronary sinus side branch stenting has also been performed in several occasions [61][62]. Finally, the development of an active fixation CS lead (Attain StarFix 4195, Medtronic) has also been achieved [63]. This lead body has a 55D polyurethane coating that expands into pleated loops near the electrode tip to increase its diameter and promote fixation (practically reaching stability of 100%), along with a small amount of steroid at the electrode tip to reduce inflammation in the surrounding tissue [64] (Figure 9).…”

Section: Removal Of Left Ventricular Pacing Leadsmentioning

confidence: 99%

Intravascular Lead Extractions: Tips and Tricks

Koulouris¹,

Metaxa²

2012

Current Issues and Recent Advances in Pacemaker Therapy

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First experience with a new active fixation coronary sinus lead

Abstract: The active fixation lead 4195 using retention lobes yielded stable thresholds over time and seems to be superior to conventional leads in terms of dislocation. However, extraction may be a difficult or even impossible task.

Cited by 44 publications

References 30 publications

Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

Reversing cardiac resynchronization therapy non-responder status in a patient with a surgically placed epicardial left ventricular lead by switching to an active fixation coronary sinus lead

Intravascular Lead Extractions: Tips and Tricks

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