(Recorded Case) From the Case Files: Difficult CIED Cases-(Recorded Case) From the Case Files: Difficult CIED Cases

Video Transcription

Video Summary

Dr. Sana Al-Khatib and Dr. Ed Cronin led a session on managing complex cardiac implantable device (CID) cases. The session included the presentation of challenging cases and advanced pacing techniques. Dr. Ryan Kunin discussed the leadless pacemaker implant approach via the internal jugular vein, highlighting its benefits for patients with challenging anatomy and difficult femoral access. He shared a case involving a patient with venous occlusions and valve replacements, successfully demonstrating the procedure's application.<br /><br />Dr. Daniel Friedman explored left bundle branch area pacing in patients with complex substrates, focusing on deploying pacing leads in scarred myocardial environments. He stressed the importance of selecting the correct pacing location and considering alternatives like biventricular pacing when left bundle branch area pacing criteria are not met. Friedman presented a case involving collaboration with coronary sinus leads for effective resynchronization.<br /><br />Dr. Siva Malpuro detailed a venoplasty procedure conducted to facilitate CRT-D through occluded veins. He emphasized strategic venous access, catheter techniques, and the importance of understanding balloon types for successful venoplasty. Malpuro's case underscored the importance of assessing anatomical details through venograms to achieve favorable outcomes using innovative techniques.<br /><br />Lastly, Dr. Maggie Infeld reviewed Bachman Bundle pacing, advocating for its physiological advantages in atrial resynchronization over traditional right atrial appendage pacing. Infeld explained the procedural steps to map and place leads optimally for restoring efficient atrial conduction and reducing atrial fibrillation incidence.<br /><br />The session encouraged a collaborative audience interaction, focusing on various techniques, potential challenges, and outcomes, underscoring the clinical importance of innovative approaches in CID management.

Keywords

cardiac implantable device

leadless pacemaker

internal jugular vein

venous occlusions

left bundle branch pacing

biventricular pacing

venoplasty procedure

CRT-D

Bachman Bundle pacing

atrial resynchronization

anatomical details

innovative techniques