A novel technique for placement of coronary sinus pacing leads in cardiac resynchronization therapy

Abstract

A new technique for the placement of left ventricular pacing leads in the tributaries of the coronary sinus (CS) is described. Antegrade visualization of the CS is accomplished by selective coronary angiography, and a hydrophilic 0.032 in. wire is advanced along the CS. This facilitates the advancement of a CS sheath over a multipurpose diagnostic catheter. A hydrophilic angioplasty wire is then utilized for the negotiation of the inferior left ventricular vein and successful placement of the left ventricular pacing lead.