TY - JOUR
T1 - Left ventricular endocardial pacing in cardiac resynchronisation therapy: Moving from bench to bedside
AU - Bracke, Frank A.
AU - van Gelder, Boukje M.
AU - Dekker, L. R. C.
AU - Houthuizen, P.
AU - ter Woorst, F. Joost
AU - Teijink, J. A.
PY - 2012/3
Y1 - 2012/3
N2 - In cardiac resynchronisation therapy, failure to implant a left ventricular lead in a coronary sinus branch has been reported in up to 10% of cases. Although surgical insertion of epicardial leads is considered the standard alternative, this is not without morbidity and technical limitations. Endocardial left ventricular pacing can be an alternative as it has been associated with a favourable acute haemodynamic response compared with epicardial pacing in both animal and human studies. In this paper, we discuss left ventricular endocardial pacing and compare it with epicardial surgical implantation. Ease of application and procedural complications and morbidity compare favourably with epicardial surgical techniques. However, with limited experience, the most important concern is the still unknown long-term risk of thromboembolic complications. Therefore, for now endovascular implants should remain reserved for severely symptomatic heart failure patients and patients at high surgical risk of failed coronary sinus implantation.
AB - In cardiac resynchronisation therapy, failure to implant a left ventricular lead in a coronary sinus branch has been reported in up to 10% of cases. Although surgical insertion of epicardial leads is considered the standard alternative, this is not without morbidity and technical limitations. Endocardial left ventricular pacing can be an alternative as it has been associated with a favourable acute haemodynamic response compared with epicardial pacing in both animal and human studies. In this paper, we discuss left ventricular endocardial pacing and compare it with epicardial surgical implantation. Ease of application and procedural complications and morbidity compare favourably with epicardial surgical techniques. However, with limited experience, the most important concern is the still unknown long-term risk of thromboembolic complications. Therefore, for now endovascular implants should remain reserved for severely symptomatic heart failure patients and patients at high surgical risk of failed coronary sinus implantation.
KW - Cardiac resynchronization therapy
KW - Left ventricular pacing
KW - Endocardial stimulation
KW - Transseptal catheterization
U2 - 10.1007/s12471-011-0210-5
DO - 10.1007/s12471-011-0210-5
M3 - Article
C2 - 22068734
SN - 1568-5888
VL - 20
SP - 118
EP - 124
JO - Netherlands Heart Journal
JF - Netherlands Heart Journal
IS - 3
ER -