Affiliation:
1. Department of Medicine Faculty of Medicine Cardiac Center King Chulalongkorn Memorial Hospital Chulalongkorn University Thai Red Cross Society Bangkok Thailand
2. Department of Medicine Faculty of Medicine Center of Excellence in Arrhythmia Research Chulalongkorn University Chulalongkorn University Bangkok Thailand
3. Division of Cardiovascular Medicine Frankel Cardiovascular Center University of Michigan Health Ann Arbor Michigan USA
Abstract
AbstractAn 80‐year‐old man with a history of complete heart block underwent dual chamber pacemaker implantation about a year ago. He returned to the hospital due to de novo heart failure caused by pacing‐induced cardiomyopathy; hence, we planned to upgrade his pacemaker to a biventricular device. The initial strategy was to perform left bundle branch area pacing‐optimized cardiac resynchronization therapy (LOT‐CRT) with left bundle branch area pacing (LBBAP) combined with a coronary sinus (CS) lead. In this challenging case, the successful placement of a CS lead was hindered by a complicated combination of a large CS body linked to the left superior vena cava and a winding CS branch. However, utilizing readily available tools, such as the coronary balloon and Guide Plus II ST catheter, proved instrumental in overcoming these obstacles. As a result, LOT‐CRT provided the patient with a safe alternative to surgical LV lead placement.
Subject
Cardiology and Cardiovascular Medicine,General Medicine