Xu Lei, Su Yangang, Qin Shengmei, Ge Junbo
Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 China.
National Clinical Research Center for Interventional Medicine, 180 Fenglin Road, Shanghai 200032, China.
Eur Heart J Case Rep. 2023 Oct 9;7(10):ytad498. doi: 10.1093/ehjcr/ytad498. eCollection 2023 Oct.
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.
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.
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.
心脏再同步治疗（CRT）已被证明对心力衰竭合并左束支传导阻滞（LBBB）的患者有益。然而，当上腔静脉通路不可行时，CRT植入具有挑战性。
一名50岁男性，有扩张型心肌病和完全性LBBB病史，因CRT治疗转诊至我院。血管造影显示左右头臂静脉闭塞。最终通过髂静脉植入心脏再同步治疗装置。随访超声心动图显示心脏功能改善，起搏系统功能正常。
髂静脉通路对于CRT植入是可行的，稳定性良好，可作为避免与开胸和心外膜导线放置相关的不必要风险的可行替代方案。
