alexa Taking any Route Possible to Achieve Cardiac Resynchronization | Open Access Journals
ISSN: 2155-9880
Journal of Clinical & Experimental Cardiology
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Taking any Route Possible to Achieve Cardiac Resynchronization

Haqeel A Jamil*, Michael Lacey and Klaus KA Witte
Leeds Institute of Genetics, Health and Therapeutics, Multidisciplinary Cardiovascular Research Centre, University of Leeds, Clarendon Way, Leeds, United Kingdom
Corresponding Author : Haqeel A Jamil
Leeds Institute of Genetics
Health and Therapeutics
Multidisciplinary Cardiovascular Research Centre
University of Leeds, Clarendon Way, Leeds
United Kingdom, LS2 9JT
Tel: (+44)1133926642
E-mail: [email protected]
Received February 08, 2014; Accepted March 29, 2014; Published April 10, 2014
Citation: Jamil HA, Lacey M, Witte KKA (2014) Taking any Route Possible to Achieve Cardiac Resynchronization. J Clin Exp Cardiolog 5:295. doi:10.4172/2155-9880.1000295
Copyright: © 2014 Jamil HA, et al. This is an open-access article distributed underthe terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Related article at
DownloadPubmed DownloadScholar Google

Visit for more related articles at Journal of Clinical & Experimental Cardiology

Keywords
Left ventricular dysfunction; Cardiac resynchronisation therapy; Heart failure; Left sided superior vena cava
An 85 year old man with non-ischaemic dilated cardiomyopathy, severe left ventricular systolic dysfunction and severe symptoms of heart failure was referred for Cardiac Resynchronisation Therapy (CRT). His resting 12 lead ECG revealed atrial fibrillation with a bradycardic ventricular response despite no rate limiting agents, and a left bundle branch block with the QRS duration of 156 ms.
Positioning of the right ventricular lead (St. Jude Optisense 1999 52cm) was straightforward via a left infraclavicular approach. Accessing the Coronary Sinus (CS) to implant the left ventricular lead was difficult due to repeated cannulation of a small parallel tributary (Figure 1 image A). Retrograde contrast venography using this vein revealed a large CS with a tight proximal stenosis, and a small persistent left sided superior vena cava (PLSVC) (Figure 1 images B and C). Access to the PLSVC was gained using a hyperacute sub-selection catheter (Medtronic Attain Select II), and a hydrophilic coated guidewire (Terumo Glidewire) was passed into the coronary sinus. The PLSV was engaged with a steerable sheath (Medtronic Attain Command system) to provide support for the sub-selection catheter which was advanced into the coronary sinus (Figure 1 image D). Antegrade venography revealed a high lateral vein, with a retrograde junction to the main CS (Figure 1 image E). The Left Ventricular (LV) lead (St Jude Quick Flex micro 1258 88cm) was successfully passed into a satisfactory position (Figure 1 image F). Lead thresholds and positions were stable at 24 hour post procedural device interrogation (Figure 2).
This case describes how standard sheath and catheter shapes used imaginatively can overcome difficult anatomy. A PLSVC is estimated to occur in 0.3% of individuals without congenital abnormalities. It is the most common venous cardiac abnormality, and is most often identified incidentally during pacemaker implantation [1]. Due to increased flow, the CS in patients with a PLSCV is often large, usually making cannulation for LV lead placement during cardiac resynchronisation therapy easy, but achieving a stable lead position more difficult. Our case demonstrates the benefit of doing a complete venogram during CRT implantation and that even a vestigial PLSCV can be used to access the CS for LV lead placement [2,3].
References



Figures at a glance

Figure Figure
Figure 1 Figure 2
Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 11687
  • [From(publication date):
    March-2014 - Nov 23, 2017]
  • Breakdown by view type
  • HTML page views : 7921
  • PDF downloads : 3766
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords