Overcoming an impossible anatomy with a novel left ventricular active fixation lead in the coronary sinus: A case report

Cardiac resynchronization therapy (CRT) has proved to be beneficial for patients with moderate-to-severe heart failure with prolonged QRS duration and reduced left ventricular ejection fraction. Placement of a left ventricular (LV) lead in an adequate location has been shown to increase response to CRT1,2 but can become a complex procedure because of challenging coronary vein anatomies. We report the case of a patient in whom a novel LV lead was successfully implanted in a very-large-diameter coronary vein.