Left ventricular endocardial pacing in cardiac resynchronisation therapy: Moving from bench to bedside

Frank A. Bracke*, Boukje M. van Gelder, L. R. C. Dekker, P. Houthuizen, F. Joost ter Woorst, J. A. Teijink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)


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.
Original languageEnglish
Pages (from-to)118-124
JournalNetherlands Heart Journal
Issue number3
Publication statusPublished - Mar 2012


  • Cardiac resynchronization therapy
  • Left ventricular pacing
  • Endocardial stimulation
  • Transseptal catheterization

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