title: Coronary Sinus Lead Positioning.
abstract: Although cardiac resynchronization therapy improves morbidity and mortality in patients with cardiomyopathy, heart failure, and electrical dyssynchrony, the rate of nonresponders using standard indications and implant techniques is still high. Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors such as cause of heart failure, type of dyssynchrony, scar burden, coronary sinus anatomy, and phrenic nerve capture may affect the efficacy of the therapy. Several modalities are under investigation. Alternative left ventricular lead implantation strategies are occasionally required when the transvenous route is not feasible or would result in a suboptimal lead position.
authors.affiliation: Cardiology Division, Cardiac Arrhythmia Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Attila
authors.initials: A
authors.lastname: Roka
authors.affiliation: Cardiology Division, Cardiac Arrhythmia Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.affiliation: Cardiology Division, Cardiac Arrhythmia Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: jsingh@mgh.harvard.edu.
authors.forename: Jagmeet
authors.initials: J
authors.lastname: Singh
mesh_terms: D058409:Cardiac Resynchronization Therapy Devices; D054326:Coronary Sinus / Q000601:surgery*; D004567:Electrodes, Implanted; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000517:prevention & control*
keywords: Cardiac resynchronization therapy; Coronary sinus; Heart failure; Pacing; Targeted lead placement