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José L. Navia
Fernando A. Atik
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Ann Thorac Surg 2005;80:751-754
© 2005 The Society of Thoracic Surgeons

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Minimally Invasive Surgical Alternatives for Left Ventricle Epicardial Lead Implantation in Heart Failure Patients

José L. Navia, MD * , Fernando A. Atik, MD

Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio

Accepted for publication March 8, 2004.

* Address reprint requests to Dr Navia, Department of Thoracic and Cardiovascular Surgery, F-25, Cleveland Clinic Foundation, 19500 Euclid Ave, Cleveland, OH44195; (Email: naviaj{at}ccf.org).

Biventricular pacing is a proven advantageous adjuvant therapy for patients with ventricular dyssynchrony associated with congestive heart failure. Endocardial left ventricular lead placement does have several limitations: anatomic variations of the coronary venous system and late lead dislodgement. Epicardial lead placement is often a rescue procedure but offers some advantages related to safety and a shorter implant time. Moreover, it allows visual selection of the best pacing site and multiplicity of pacing sites. Three minimally invasive surgical methods of left ventricular lead placement are outlined in this article, including specific indications and limitations. Biventricular pacing has been proposed as an adjuvant treatment for patients with heart failure and intraventricular conduction delay.






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Copyright © 2005 by The Society of Thoracic Surgeons.