Abstract
There is compelling data to place the coronary sinus lead (CSL) in a lateral or posterolateral tributary. Coronary sinus venography often demonstrates the absence of easily accessible lateral veins or those with sufficient size to accommodate the CSL. The operator may choose to deploy the CSL in the anterior vein but publications and experience highlight the lack of resynchronization benefit when the CSL is deployed in this location. There is often a posterolateral vessel or the middle cardiac vein (MCV) originating from near the coronary sinus (CS) os. These vessels require the operator to pull the CS guide essentially out of the CS to allow successful access. Cannulation of the coronary sinus (CS) is often challenging, and the risk of losing access to the CS may dissuade the implanter from attempting access to a vessel near the CS os. We describe a technique to access vessels near the CS os while maintaining secure position in the main body of the CS.
References
Butter C, Auricchio A, Stellbrink C, Fleck E, Ding J, Yu Y, Huvelle E, Spinelli J. Pacing Therapy for Chronic Heart Failure II Study Group. Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients.Circulation 2001;104:3026–3029.
Auricchio A, Ding J, Spinelli JC, Kramer AP, Salo RW, Hoersch W, KenKnight BH, Klein HU. Cardiac resynchronization therapy restores optimal atrioventricular mechanical timing in heart failure patients with ventricular conduction delay.J Am Coll Cardiol 2002;39:1163–1169.
Butter C, Auricchio A, Stellbrink C, Schlegl M, Fleck E, Horsch W, Huvelle E, Ding J, Kramer A. Should stimulation site be tailored in the individual heart failure patient?Am J Cardio 2000;86:K144–K151.
Rossillo A, Verma A, Saad EB, Corrado A, Gasparini G, Marrouche NF, Golshayan AR, McCurdy R, Bhargava M, Khaykin Y, Burkhardt JD, Martin DO, Wilkoff BL, Saliba WJ, Schweikerto RA, Raviele A, Natale A. Impact of coronary sinus lead position on biventricular pacing:Mortality and echocardiographic evaluation during long-term follow-up.J Cardiovasc Electrophysiol 2004;14:1120–1125.
von Ludinghausen M. Clinical anatomy of cardiac veins, Vv. cardiacae.Surg Radiol Anat 1987;9:159–168.
Asirvatham SJ. Biventricular device implantation. In:Hayes DL, Wang PJ, Scakner-Bernstein J, Asirvatham SJ, eds. Resynchronization and Defibrillation for Heart Failure. Oxford:Blackwell-Futura, 2004;99–137.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Perzanowski, C., Gilliam, F.R. The Buddy Wire Technique: Accessing Lateral Coronary Veins While Maintaining Coronary Sinus Position. J Interv Card Electrophysiol 13, 231–234 (2005). https://doi.org/10.1007/s10840-005-2494-0
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10840-005-2494-0