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Epicardial left ventricular lead implantation for cardiac resynchronization therapy: case report
Author(s) -
Shen Farong,
Huang Shuwei,
Wang Zhijun,
Chen Jianming,
Ling Feng,
Jin Hongfeng,
Lv Feng,
He Rengliang,
Xia Yu,
Xia Qiang
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.6.a1367-b
Subject(s) - medicine , cardiology , cardiac resynchronization therapy , ventricle , coronary sinus , heart failure , ventricular dyssynchrony , ejection fraction
A 33‐year‐old male with dilated cardiomyopathy presented with heart failure symptoms in the absence of angina. Several hospitalizations were required due to heart failure exacerbation. Electrocardiography and tissue synchronization imaging confirmed ventricular dyssynchrony, requiring biventricular pacing. After a failed attempt of percutaneous placement of the left ventricular lead because of anomaly of coronary venous sinus, an epicardial left ventricular lead implantation was indicated. We conducted a conventional right atrial septal and ventricular septal pacing leads placement via the infraclavicular subclavian route, and two epicardial leads implantation to the lateral‐posterior wall of the left ventricle through thoracotomy under general anesthesia. The postoperative recovery was satisfactory, with reestablishment of the ventricular synchrony and regular rhythm and improvement of clinical symptoms. The distance of the 6 min steps increased from 100 meters to 300 meters and the cardiac function was improved (NYHY grade: from III~IV to II~III). Ultrasound examination showed that the cardiac/chest ratio was reduced, left ventricular diastolic dimension was decreased from 72 mm to 66 mm, and the mitral regurgitation decreased. This is the first case in China to apply epicardial left ventricular lead implantation for cardiac resynchronization therapy.