Efficacy of coronary venoplasty for left ventricular lead implantation.
BACKGROUND
Optimal target vein selection for the pacing lead results in a better outcome, but left ventricular (LV) variability limits this selection. The aim of the present study was to investigate the efficacy of coronary venoplasty for insertion of a LV lead.


RESULTS
Transvenous LV lead placement was attempted in 208 consecutive patients from November 2002 to January 2007, with success in 206 patients (99%). Retrospective analysis of the cardiac resynchronization therapy system implantation showed that 4 of the 206 patients (1.9%) required coronary venoplasty for insertion of the pacing lead implant. Using coronary balloon angioplasty catheters of 2.5 mm (2 patients), 3.0 mm (1 patient) and 4.0 mm (1 patient), each target vein was dilated. Of 4 patients, stenoses in 3 were dilated by balloon angioplasty only. However, focal stenosis of 1 patient was not able to be dilated due to severe stenosis. Therefore, part of the lesion was sharpened by rotational atherectomy and the stenosis was successfully dilated. The LV pacing lead could then be inserted and no complications occurred.


CONCLUSIONS
Venoplasty for stenosis was effective in allowing deployment of a LV lead into a target vein in some patients. The safety and complications of the procedure remain unclear.
Soga
Yoshimitsu
Y
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Ando
Kenji
K
Yamada
Takashi
T
Goya
Masahiko
M
Shirai
Shinichi
S
Sakai
Koyu
K
Iwabuchi
Masashi
M
Yasumoto
Hitoshi
H
Yokoi
Hiroyoshi
H
Nosaka
Hideyuki
H
Nobuyoshi
Masakiyo
M
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002304:Cardiac Pacing, Artificial; D023921:Coronary Stenosis / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial