A Randomized Comparison of Alternative Techniques to Achieve Coronary Sinus Cannulation During Biventricular Implantation Procedures

Abstract

Cannulation of CS with the adjunct of an electrophysiology catheter to dedicated delivery systems significantly reduces procedural time, fluoroscopy time and contrast dye volume compared to a conventional strategy.

Implantation of Left Ventricular Leads Using a Telescopic Catheter System

“…Indeed, the use of an IC with a preshaped tip helped the selection of the target vein. We also found that the A is significantly faster than the R system in terms *For this study, 14 there are reported only the patients assigned to the GCA (guiding catheter alone positioning strategy), cannulation strategy. of the median time for LV lead positioning.…”

“… *For this study, 14 there are reported only the patients assigned to the GCA (guiding catheter alone positioning strategy), cannulation strategy. …”

“…Contrast venography is often performed during the procedure with an occlusive balloon catheter, after CS cannulation. The following catheters have been used: (1) fixed‐curve or deflectable electrophysiologic mapping catheters inside a guiding catheter 14 ; (2) shaped guiding catheters with a soft‐tipped guide wire 4,14 ; or (3) diagnostic coronary catheters (i.e., multipurpose MP, Amplatz A2) inserted into a guiding catheter 13 . This report describes our experience with two different telescoping catheter systems consisting of an inner catheter (IC) and an outer catheter (OC), specifically designed for CS cannulation and LV lead placement.…”

“…1 A CRT implantation success rate of 91.6% 2 was recently reported in a multicenter study that evaluated outcomes of transvenous CRT systems in over 2,000 patients from the Multicenter InSync Randomized Clinical Evaluation (MIRACLE), the MIRACLE Implantable Cardioverter Defibrillator (ICD), and the InSync III study. 2 Several techniques [3][4][5][6][7][8][9][10][11][12][13][14] have been proposed for LV lead implantation. Contrast venography is often performed during the procedure with an occlusive balloon catheter, after CS cannulation.…”

The Inferior Radiolucent Area Within the Cardiac Silhouette: Validation as a Landmark for Coronary Sinus Catheterization

“…Different maneuvers for CS cannulation, such as preshaped guiding sheaths, 5,6 using a steerable electrophysiological catheter as a guide, 5,7 and over‐the‐wire pacing lead systems, 8 have been recommended in the past. Intracardiac echocardiography 9 and transesophageal echocardiography 10 have also been suggested for assisting CS catheterization in difficult cases.…”