Cor Vasa 2010, 52(9):489-493 | DOI: 10.33678/cor.2010.134

Thoracoscopic left ventricular epimyocardial lead implantation for biventricular pacing

Marek Pojar1,*, Jan Vojáček1, Miloslav Tauchman2, Petr Pařízek2, Aleš Havlíček3, Jan Bělohlávek3
1 Kardiochirurgická klinika, Fakultní nemocnice Hradec Králové a Lékařská fakulta v Hradci Králové Univerzity Karlovy v Praze, Kardiocentrum, Fakultní nemocnice Hradec Králové
2 I. interní klinika, Fakultní nemocnice Hradec Králové a Lékařská fakulta v Hradci Králové Univerzity Karlovy v Praze, Kardiocentrum, Fakultní nemocnice Hradec Králové
3 Invazivní arytmologie Artur KOBLITZ, s. r. o., Pardubice, Kardiocentrum, Fakultní nemocnice Hradec Králové, Česká republika

Introduction: Cardiac resynchronization therapy is a therapeutic option in patients with congestive heart failure. Surgical epicardial lead placement for biventricular pacing is the method of choice after failed coronary sinus (CS) cannulation. We describe our initial experience with minimally invasive surgical lead implantation using video-assisted thoracoscopy.

Methods: From August 2008 to January 2010, a total of 12 patients (mean age 71.9 ± 8.9 years) with congestive heart failure, NYHA functional class 2.9 ± 0.3 and depressed ejection function (25.5 ± 5.0%) were referred for surgery because of failed CS left ventricular lead implantation. Under single-lung ventilation and video-assisted thoracoscopy, epimyocardial steroid-eluting screw-in leads were implanted on the left ventricular free wall.

Results: There were no in-hospital deaths. Mean skin-to-skin operating time was 124.2 ± 34.6 minutes and the postoperative average length of stay was 8.3 ± 2.4 days. Intraoperative threshold capture of the left ventricular lead was 0.85 ± 0.58 V/0.5 ms. Conversion to a small thoracotomy was necessary in one patient due to bleeding.

Conclusion: Minimally invasive left ventricular lead implantation is a relatively safe procedure with excellent threshold capture.

Keywords: Cardiac resynchronization therapy; Lead implantation; Thoracoscopy

Published: September 1, 2010  Show citation

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Pojar M, Vojáček J, Tauchman M, Pařízek P, Havlíček A, Bělohlávek J. Thoracoscopic left ventricular epimyocardial lead implantation for biventricular pacing. Cor Vasa. 2010;52(9):489-493. doi: 10.33678/cor.2010.134.
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