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Alternative Method for Cardiac Resynchronization: Transapical Lead Implantation

^a Gottsegen Gyorgy Hungarian Institute of Cardiology, Budapest, Hungary
^b Department of Clinical Electrophysiology, Thoraxcentre, Erasmus Medical Center, Rotterdam, the Netherlands

Accepted for publication April 23, 2008.

^_* Address correspondence to Dr Szili-Torok, Department of Clinical Cardiac Electrophysiology, Thoraxcentre, Erasmus Medical Center, Rotterdam, 3000 CA, the Netherlands (Email: t.szilitorok{at}erasmusmc.nl).

Alternative methods are necessary for cardiac resynchronization therapy when coronary sinus lead implantation fails. We aim to describe a fundamentally new approach using transapical implantation of an active fixation endocardial pacing lead. This technique is based on direct puncture of the left ventricular apex using the standard Seldinger technique. The tip of the lead is positioned with intracavital navigation under fluoroscopy. This method offers advantages for cardiac resynchronization because it is minimally invasive, provides endocardial pacing, and does not involve the mitral valve.