title: Left ventricular lead positioning in cardiac resynchronization therapy: an innovative retrograde approach without using snare.
abstract: OBJECTIVE
  Ideal positioning of left ventricular (LV) pacing lead in cardiac resynchronization therapy (CRT) is technically demanding. This case aims to place LV lead in anterolateral branch of coronary sinus (CS) using collateral route blindly.
  
  
  RESULTS
  Externalization via the CS ostium using collaterals retrogrogradely, which was not visible in initial balloon occlusion venography, through one delivery sheath with the support of commonly used micro-guide catheter and subsequent successful LV lead placement in anterolateral branch of CS.
  
  
  CONCLUSIONS
  This innovative retrograde approach for LV pacing lead implantation in anterolateral branch of CS obviated the need for snare technique to capture the distal end of the wire when antegrade route was not successful.
authors.affiliation: Binawaluya Cardiac Center, 13750 Jakarta, Indonesia.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: Binawaluya Cardiac Center, 13750 Jakarta, Indonesia Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, 10430 Jakarta, Indonesia muna@cbn.net.id.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Munawar
authors.affiliation: Binawaluya Cardiac Center, 13750 Jakarta, Indonesia.
authors.forename: Dian Andina
authors.initials: DA
authors.lastname: Munawar
authors.affiliation: Binawaluya Cardiac Center, 13750 Jakarta, Indonesia.
authors.forename: Beny
authors.initials: B
authors.lastname: Hartono
authors.affiliation: Binawaluya Cardiac Center, 13750 Jakarta, Indonesia.
authors.forename: Vito
authors.initials: V
authors.lastname: Damay
mesh_terms: D001282:Atrial Flutter / Q000150:complications / Q000601:surgery*; D054537:Atrioventricular Block / Q000150:complications / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy; D058409:Cardiac Resynchronization Therapy Devices; D017115:Catheter Ablation; D054326:Coronary Sinus; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000628:therapy*
keywords: Cardiac resynchronization therapy; Collateral vein; Congestive heart failure; Coronary sinus; Left ventricular lead positioning