The coronary venous anatomy: a segmental approach to aid cardiac resynchronization therapy.
The coronary sinus is the gateway for left ventricular (LV) epicardial lead placement for cardiac resynchronization therapy. The implanting electrophysiologist is usually challenged by a high degree of variability in the coronary venous anatomy, making it important to have a more consistent and uniform segmental approach to describe the coronary venous tree and its branches. Classifying the coronary sinus branches and tributaries by the segment of their location rather than by conventional anatomic names (i.e., middle cardiac vein, great cardiac vein, and so on), would provide more relevant anatomic and functional information at the time of LV lead placement. This would enable the implanting physician to proactively correlate the venous anatomy with the segmental wall motion abnormalities or dyssynchrony, as defined by echocardiography and other imaging modalities. The current viewpoint calls for a more systematic segmental approach for describing the coronary venous anatomy.
Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. jsingh@partners.org
Jagmeet P
JP
Singh
Stuart
S
Houser
E Kevin
EK
Heist
Jeremy N
JN
Ruskin
D002304:Cardiac Pacing, Artificial; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000033:anatomy & histology*; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D010690:Phlebography; D009626:Terminology as Topic; D014057:Tomography, X-Ray Computed