Cardiac resynchronization therapy from an iliac approach in a patient without superior access: a case report

Author:

Xu Lei12ORCID,Su Yangang12,Qin Shengmei12ORCID,Ge Junbo12ORCID

Affiliation:

1. Department of Cardiology, Zhongshan Hospital, Fudan University , 180 Fenglin Road , Shanghai 200032 China

2. National Clinical Research Center for Interventional Medicine , 180 Fenglin Road, Shanghai 200032 , China

Abstract

Abstract Background Cardiac resynchronization therapy (CRT) has been shown to benefit patients with heart failure and left bundle branch block (LBBB). However, CRT implantation is challenging when the superior venous access is not feasible. Case summary A 50-year-old man with a history of dilated cardiomyopathy and complete LBBB was referred to our hospital for CRT management. Angiography showed that the left and right brachiocephalic veins were occluded. Cardiac resynchronization therapy was finally implanted via the iliac vein. Follow-up echocardiography showed improved cardiac function, and the pacing system was functioning properly. Discussion The iliac vein access is feasible for CRT implantation with good stability, which can be a viable alternative to avoid unnecessary risk associated with thoracotomy and epicardial lead placement.

Funder

National Natural Science Foundation of China

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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