Usefulness of a novel active fixation left ventricle lead in cardiac resynchronization therapy

Abstract

Cardiac resynchronization therapy has demonstrated important benefits for selected patients suffering from heart failure. Those benefits include clinical and/or echocardiography assessed improvement, as well as hospitalizations and all-cause mortality reduction. However, about 30% of patients do not benefit from the therapy. Suboptimal left ventricle lead position, post-implant lead dislodgements and undesired phrenic nerve stimulation are potential causes for not responding and it is not always possible to avoid them during the implant procedure. We report a case in which we used a novel left ventricle lead which is actively fixated to the cardiac vein or to the coronary sinus, by means of a helix, in a patient with very limited options to implant the lead. In this patient, a traditional, passively fixated lead would fail to get implanted. This design can help the implanting physician to implant the lead in the desired position, minimizing the possibility of dislodgement, even in very basal positions where traditional leads are more likely to dislodge.