[Efficacy of minimally invasive left ventricular epicardial lead placement for cardiac resynchronization therapy].
OBJECTIVE
Ventricular resynchronization might be achieved via minimally invasive left ventricular epicardial lead placement.


METHODS
Six patients with congestive heart failure underwent minimally invasive left ventricular epicardial lead placement after failed coronary sinus cannulation were followed up for 1 year, cardiac function and LV lead threshold were evaluated.


RESULTS
There were no in-hospital deaths, intraoperative complications and diaphragm stimulation. Correct lead positioning was achieved in all 6 patients. LV lead thresholds remained unchanged [(1.2 ± 0.5) V vs (1.1 ± 0.4) V, P = 0.68] at 12 months follow-up. Improvements on 6 min walking test [(327 ± 77) m vs (267 ± 68) m, P = 0.001], LVEF [(26.1 ± 6.0)% vs (38.2 ± 4.7)%, P = 0.004], and NYHA functional class were evidenced at 12 months follow-up.


CONCLUSIONS
Minimally invasive left ventricular epicardial lead placement is a safe and reliable technique and should be considered as an alternative option in case of difficult coronary venous anatomy and inability to position the lead for resynchronization therapy.
Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Yun-long
YL
Wang
Xue-jun
XJ
Ren
Wen-bin
WB
Li
Jin-sheng
JS
Xie
Teng-yong
TY
Jiang
Zhi-hong
ZH
Han
Fang
F
Chen
Ji-hong
JH
Guo
D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D058406:Cardiac Resynchronization Therapy; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000601:surgery*