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Cardiac Resynchronization Therapy from an Iliac Approach in a Patient Without Superior Access: a Case Report

Overview
Journal Eur Heart J Case Rep
Publisher Oxford University Press
Specialty Cardiology & Vascular Diseases
Date 2023 Oct 23
PMID 37869735
Authors
Lei Xu
Yangang Su
Shengmei Qin
Junbo Ge
Affiliations
Soon will be listed here.
Abstract

Background: Cardiac resynchronization therapy (CRT) has been shown to benefit patients with heart failure and left bundle branch block (LBBB). However, CRT implantation is challenging when the superior venous access is not feasible.

Case Summary: A 50-year-old man with a history of dilated cardiomyopathy and complete LBBB was referred to our hospital for CRT management. Angiography showed that the left and right brachiocephalic veins were occluded. Cardiac resynchronization therapy was finally implanted via the iliac vein. Follow-up echocardiography showed improved cardiac function, and the pacing system was functioning properly.

Discussion: The iliac vein access is feasible for CRT implantation with good stability, which can be a viable alternative to avoid unnecessary risk associated with thoracotomy and epicardial lead placement.

Citing Articles

Left bundle branch area pacing from the iliac approach in a patient without superior access: a case report.

Xu L, Su Y, Qin S, Ge J Eur Heart J Case Rep. 2025; 9(2):ytae486.

PMID: 39935822 PMC: 11811417. DOI: 10.1093/ehjcr/ytae486.

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