Journal: European Heart Journal: Case Reports

Article Title: Cardiac resynchronization therapy in patients with a coronary sinus reducer: a case series

doi: 10.1093/ehjcr/ytad455

Figure Lengend Snippet: ( A ) The CSR is passed using a guidewire (arrow) and a 9 F Biotronik (9 F; Berlin, Germany) delivery sheath (marked with *). The RV ICD lead is located in the inferoseptal region (RV). The CSR is passed by the delivery sheath (CS). ( B and C ) Angiogram of the CS via the 9 F delivery sheath that passes the CSR shows no significant obstruction. ( D ) Anterolateral LV lead placement over the delivery sheath that is pulled back to the beginning of the CSR. The RV ICD and right atrial leads are located in the right atrial appendage. ( E ) Final anterolateral LV lead position; the posterolateral side branch is not suitable due to phrenic capture. CS, coronary sinus; CSR, coronary sinus reducer; ICD, implantable cardioverter defibrillator; LV, left ventricular lead; RV, right ventricular lead.

Article Snippet: The guidewire and LV lead (Sentus QP 85; Biotronik) were advanced over the narrow portion of the CSR, and the LV lead was placed in a posterolateral vein of the CS.

Techniques:

Journal: European Heart Journal: Case Reports

Article Title: Cardiac resynchronization therapy in patients with a coronary sinus reducer: a case series

doi: 10.1093/ehjcr/ytad455

Figure Lengend Snippet: ( A ) Radiograph after CSR implantation 52 months before CRT. ( B ) Implantation of the CSR with (1) dislocation of the LV pacemaker lead (marked with *) (2) within the procedure. Finally (3), the lead is dislocated into the main CS and fixed between the reducer (X) and endothelium of the CS. ( C ) (1) Guidewire with intention to relocate the LV lead in the initial target vein (LV) (marked with *). (2) Retraction of the trapped LV lead with manual traction without any relevant dislocations and complications due to challenging repositioning of the LV lead. ( D ) (1) Cannulating the CS with the IS and illustration of the coronary sinus with contrast medication showing the stenosing effect of the CSR (CS). Right ventricular lead (RV) placed inferoseptally. (2) After cannulating the coronary sinus passage of the CSR via guidewire (GW) and advancement of the LV lead (LV) to the end of the IS. ( E ) (1) AP view with the LV lead (LV) advanced over the CSR (CS) into the target vein (lateral); right atrial lead (RA) located laterally. (2) LAO view showing the laterally placed LV lead and IS located at the beginning of the CSR. AP, anterior posterior; CS, coronary sinus; CSR, coronary sinus reducer; IS, introducer sheath; LAO, left anterior oblique; LV, left ventricular lead; RV, right ventricular lead.

Article Snippet: The guidewire and LV lead (Sentus QP 85; Biotronik) were advanced over the narrow portion of the CSR, and the LV lead was placed in a posterolateral vein of the CS.

Techniques:

Journal: European Heart Journal: Case Reports

Article Title: Cardiac resynchronization therapy in patients with a coronary sinus reducer: a case series

doi: 10.1093/ehjcr/ytad455

Figure Lengend Snippet: ( A ) Computed tomography showing the aneurismatic dilated aorta ascendens (Asc), bypass via a right subclavial vein to a femoralis communis (arrows), and proximal and distal parts of the non-fully expanded intra-aortic stent in the abdominal aorta (*). ( B ) Chest radiograph before CRT implantation showing the abandoned intra-aortic stent with the trapped introducer tools (arrow). ( C ) (1) Cannulating the CS with the steerable catheter (BARD), PFO occluder (PFO), abandoned intra-aortic stent (arrow) passing the CSR (CS), and RV lead (RV). (2) The LV lead (LV) is still in the IS located in front of the CSR, and the guidewire (GW) placed in the main coronary sinus. (3) Advancing the LV lead through the CSR. ( D ) Guidewire (GW) advanced into the target vein (posterolateral), with the LV lead being pushed over the guidewire into the final posterolateral position—marked with arrows (1 and 2). ( E ) Final result, atrial lead (RA) located antero-laterally, right ventricular lead (RV) inferoseptally/apically and left ventricular lead (LV) through the CSR (CS) within the posterolateral side branch of the CS together; PFO occluder marked with *, a stented right coronary artery and the abandoned aortic stent with the introducer marked with an arrow. CS, coronary sinus; CSR, coronary sinus reducer; IS, introducer sheath; LV, left ventricular lead; PFO, patent foramen ovale; RV, right ventricular lead.

Article Snippet: The guidewire and LV lead (Sentus QP 85; Biotronik) were advanced over the narrow portion of the CSR, and the LV lead was placed in a posterolateral vein of the CS.

Techniques: Computed Tomography

Journal: Journal of Arrhythmia

Article Title: Proarrhythmic effect of bipolar epicardial left ventricular stimulation in CRT resolved maintaining biventricular pacing with unipolar‐cathodical configuration: A peculiar case report

doi: 10.1002/joa3.12818

Figure Lengend Snippet: Postimplantation posteroanterior chest X‐ray. The postimpltantation chest X‐ray confirmed the correct position of the quadripolar left ventricular lead into the posterolateral coronary sinus tributary vein.

Article Snippet: The quadripolar LV lead (Sentus OTW QP, Biotronik) was advanced into the posterolateral coronary sinus tributary vein (Figure ).

Techniques: