Total thoracoscopic left ventricular lead implantation for hybrid cardiac resynchronization therapy in pacemaker-mediated cardiomyopathy

Yu Inaba, Tsutomu Ito, Sachiko Hayashi, Tatsuo Takahashi, Yoshimasa Inoue, Teruhiro Aoki, Hideyuki Takimura, Tsuyoshi Sakai, Takahiko Misumi, Hideyuki Shimizu

Research output: Contribution to journalArticle

Abstract

Cardiac resynchronization therapy (CRT) has been increasingly performed in patients having heart failure with dyssynchrony. We report a successful case of total thoracoscopic left ventricular (LV) lead implantation in CRT. A 77-year-old man with marked dyssynchrony of the LV wall motion and a low ejection fraction (EF17%) due to pacemaker-mediated cardiomyopathy was referred to us. CRT was planned, but percutaneous LV lead implantation proved difficult owing to anatomical variations. The LV lead was placed in the post-lateral wall of the LV base using a total thoracoscopic procedure. Preoperative dyspnea and dyssynchrony were clearly improved. In CRT, the LV wall stimulation site is important. The LV lead should be implanted in the latest activation area, which can be detected using speckle tracking echocardiography. Surgical lead implantation can be performed in the ideal area, and this procedure may play a new role as a hybrid CRT.

Original languageEnglish
Pages (from-to)1-4
Number of pages4
JournalGeneral Thoracic and Cardiovascular Surgery
DOIs
Publication statusAccepted/In press - 2017 Feb 28

Keywords

  • Cardiac resynchronization therapy
  • Epicardial lead implantation
  • Speckle tracking echocardiography
  • Thoracoscopic surgery

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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