Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Implantation D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-097 - Microcatheter: A Useful Tool For Difficult LV Lead Implantation (ID 435)

 F. Zou: Nothing relevant to disclose.


Background: A 0.014-in lumen hydrophilic plastic catheter (microcatheter) is not commonly used in EP device implantation but is commonly used in other interventional procedures. When a wire is advanced into the coronary venous circulation it may become bent and can no longer be advanced. In other cases, the advanced wire does not provide sufficient support to forward the vein selector/sub-selector/pacing lead.
Objective: To illustrate the use of microcatheters in LV lead implantation.
Methods: We report 12 cases where a microcatheter was used to facilitate LV lead placement.
Results: In 5 cases, the wire that traversed the collaterals would not exit the adjacent vein to the CS. In 4 cases, the wire initially advanced into the target vein would not advance more than 1-cm before the tip became bent, preventing the wire from advancing further. In 3 cases, the wire alone did not provide adequate support to advance the vein selector sub-selector combination into the vein for LV delivery. With the aid of a microcatheter, LV leads were successfully implanted in all patients.
Conclusion: A 0.014-in microcatheter is commonly available from multiple sources and facilitates LV lead placement. Implanting physicians should be aware that microcatheters exist and include the use of a microcatheter in their approach to difficult LV lead placement.