Biventricular ICD implant using endocardial LV lead placement from the left subclavian vein approach and transseptal puncture via the transfemoral route.
We present the case of a 72 years old diabetic male patient with severe dilated ischaemic cardiomyopathy and New York Heart Association functional class III symptoms and previous unsuccessful attempts to cardiac resynchronization therapy using the conventional epicardial left ventricular (LV) pacing through the coronary sinus. He also had an indication for ICD implantation. We successfully implanted a biventricular ICD system from the standard left subclavian vein approach using endocardial placement of the LV lead via a transfemorally performed transeptal puncture. This technique offered him a suitable alternative to either a thoracoscopic LV lead placement (not routinely performed in our centre) or a high-risk thoracotomy procedure and multisite pacing using epicardial leads.
Nuta
Bogdan
B
South West Cardiothoracic Centre, Department of Cardiology, Derriford Hospital, Derriford Road, Plymouth, Devon PL6 8DH, UK. bnuta@doctors.org.uk
Lines
Ian
I
MacIntyre
Inga
I
Haywood
Guy A
GA
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000628:therapy; D017147:Defibrillators, Implantable; D004699:Endocardium / Q000294:innervation* / Q000503:physiopathology; D005268:Femoral Vein; D006352:Heart Ventricles / Q000294:innervation* / Q000503:physiopathology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D013350:Subclavian Vein; D054088:Ventricular Septum