Challenging Implants Require Tools and Techniques Not Tips and Tricks

Seth J Worley

doi:10.1016/j.ccep.2018.11.003

Challenging Implants Require Tools and Techniques Not Tips and Tricks

Card Electrophysiol Clin. 2019 Mar;11(1):75-87. doi: 10.1016/j.ccep.2018.11.003.

Author

Seth J Worley¹

Affiliation

¹ Cardiac Electrophysiology Division, Medstar Heart and Vascular Institute, 110 Irving Street Northwest, Suite 5A-12, Washington, DC 20010, USA. Electronic address: seth@mcworley.com.

PMID: 30717855
DOI: 10.1016/j.ccep.2018.11.003

Abstract

The EP Clinics article "How to implant CRT devices in a busy clinical practice" describes the basics of the "interventional telescoping technique". This article focuses on specific circumstances where the tools and techniques are invaluable: (1) inability to locate the coronary sinus (CS), (2) inability to advance a catheter into the CS, (3) patients with CS atresia, (4) unstable CS access, (4) angulated target veins, (5) small and/or tortuous target veins, (6) target veins into which a wire cannot be advanced, (7) target veins with a drain pipe takeoff, (8) target veins close to the CS ostium.

Keywords: Amplatz support wire technique; Amplatz wire; Anchor balloon; Antidromic snare technique; CS atresia; CS cannulation; Orthodromic snare technique; Vein selectors.

Publication types

Review

MeSH terms

Cardiac Pacing, Artificial*
Coronary Sinus / surgery*
Electrodes, Implanted*
Humans
Pacemaker, Artificial
Prosthesis Implantation* / instrumentation
Prosthesis Implantation* / methods