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Cardiac resynchronization results in significant clinical improvement in patients with moderate-to-severe heart failure and an intraventricular conduction delay.1 However, the ability to place stable pacing leads in the coronary sinus tributaries for left ventricular (LV) pacing remains a major limiting factor. The implanting electrophysiologist usually is challenged by a high degree of variability in the coronary venous anatomy.2 We describe a case of successful delivery of the LV lead to the distal region of a tortuous lateral vein using the anchor balloon technique.

Implantation of a cardiac resynchronization therapy device using the anchor balloon technique in a patient with a tortuous coronary sinus branch