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Ann Thorac Surg 2005;79:1025
© 2005 The Society of Thoracic Surgeons


New technology

INVITED COMMENTARY

Lynda Mickleborough, MD

1221 Gervais Rd, RR #1, Waubaushene, Ontario, Canada L0K 2C0

l.mickleborough{at}on.aibn.com

This article demonstrates the effectiveness of a new tool for epicardial lead placement that has been developed by Medtronic. It represents a modification of a previously marketed device used for implantation of screw-in epicardial leads. The malleable shaft allows perpendicular positioning of the lead on the posterolateral surface of the left ventricle when approached through a left anterolateral minithoracotomy. The paper describes successful positioning of the lead in 7 patients with congestive heart failure. Advantages of the approach that allow placement of the lead through a small incision, with minimal manipulation of the heart, are obvious. One important aspect of the technique is not clearly discussed in this report. How was optimal positioning of the posterolateral lead determined? Were hemodynamic measurements made, and if so, how were they used to guide lead placement? I believe that this new device will prove to be very useful in patients with heart failure who require a minimally invasive approach to biventricular pacing.


Related Article

Facilitated Minimally Invasive Left Ventricular Epicardial Lead Placement
Nicolas Doll, Ulrich T. Opfermann, Ardawan J. Rastan, Thomas Walther, Hendrik Bernau, Jan F. Gummert, and Friedrich W. Mohr
Ann. Thorac. Surg. 2005 79: 1023-1025. [Abstract] [Full Text] [PDF]



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G. Bisleri, T. Bottio, and C. Muneretto
Minimally Invasive Surgical Placement of Left Ventricular Epicardial Lead: Letter 1
Ann. Thorac. Surg., January 1, 2006; 81(1): 407 - 407.
[Full Text] [PDF]


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