Cerclage para-Hisian septal pacing through the septal perforator branch of the great cardiac vein: bedside-to-bench development of a novel technique and lead

Physiologic biventricular pacing is an attractive alternative to conventional right ventricular (RV) pacing in the management of conduction system disease.1 RV septal pacing is effective but dogged by lead instability2,3 and occasional serious tricuspid valve injury.4 Permanent His-bundle pacing has been achieved,5-11 but challenges remain including high pacing threshold, low ventricular electrogram amplitude, lead instability, and procedural complexity.12 We recently described an alternative pacemaker lead trajectory to achieve physiologic pacing, by lead implantation into the interventricular septum through the septal perforator branch of the great cardiac vein, the terminal branch of the coronary sinus.

Source: Heart Rhythm - August 29, 2019 Category: Cardiology Authors: Min Soo Cho, Min Ku Chon, Jin Hee Choi, Ki Won Hwang, Jeong-Wook Seo, Robert J. Lederman, June Hong Kim, Gi-Byoung Nam Source Type: research