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Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy  Manuel.

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Presentation on theme: "Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy  Manuel."— Presentation transcript:

1 Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy  Manuel Doblado-Calatrava, MD, Damián Sánchez-Quintana, MD, PhD, Juan José García-Guerrero, MD, PhD, Gonzalo Pizarro, MD, Joaquín Fernández de la Concha, MD  HeartRhythm Case Reports  Volume 1, Issue 5, Pages (September 2015) DOI: /j.hrcr Copyright © 2015 Heart Rhythm Society Terms and Conditions

2 Figure 1 A: This dissection is a view from the front displaying the left anterior descending artery (DA) running the anterior interventricular septum. Parts of the ventricular anterior wall were removed. Note the steerable sheath and guidewire (GW) coming from the superior caval vein (SCV) passing through the tricuspid valve (TV) and being placed in the left ventricle after interventricular septum (IS) puncture. B: Intracardiac echocardiography image: First puncture performed with a slightly oblique course across the interventricular septum. C: Intracardiac echocardiography image: Subsequent puncture performed in a more basal localization with a perpendicular orientation to the interventricular septum. D: A fluoroscopic left anterior oblique projection showing a deflectable sheath with an active-fixation bipolar pacing lead (SL) in the left ventricle, a right ventricular lead (RVL), a right atrium lead (AL), and the intracardiac echocardiography probe (*). Ao = aorta; PT = pulmonary trunk; LAA = left atrial appendage; MV = mitral valve; RV = right ventricle. HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

3 Figure 2 A: Intracardiac echocardiography image: Active-fixation bipolar pacing lead (L) delivered into the endocardial wall of the left ventricle (LV). MV = mitral valve; RV = right ventricle; IS = interventricular septum. B: Fluoroscopic left anterior oblique projection showing the final lead position into the left ventricle (LVL), a right atrium lead (AL), and a right ventricular lead (RVL). C: Post procedure resynchronization electrocardiogram. HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

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