Advancements in ‘Over-the-Wire” Versus Stylet-Guided Left Ventricular Leads
Although the implantation success rate does not differ significantly between over-the-wire and stylet leads, procedure duration, fluoroscopy time, and perioperative complication decrease when an over-the-wire left ventricular lead is primarily implanted by experienced teams. This novel lead, sometimes combined with coronary vein angioplasty [8, 9], represents a decisive improvement of the technique, especially for pacing of the left ventricle in the optimal spot. Despite all these efforts, a 100% success rate will probably never be reached by the endovascular approach. A surgical approach via a minimally invasive thoracotomy should be considered for those 5% of patients in whom endovascular CRT device implantation has failed.
KeywordsCardiac Resynchronisation Therapy Coronary Sinus Fluoroscopy Time Jude Medical Biventricular Pace
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