You Won't Find it in the Guidelines! Ask the Master-Case Presentation (Presenter: Charles A. Henrikson, MD, FHRS)

Video Transcription

Video Summary

Dr. Charles Henrickson presented a case of a 79-year-old man with an ischemic cardiomyopathy and substantial COPD who had an erosion of his generator. The patient underwent a left-sided primary prevention by the ICD five years ago which resulted in improvement in heart failure symptoms. The patient had since progressed to persistent atrial fibrillation and had an AV node ablation. Dr. Henrickson discussed the options for re-implanting a device, including minimal pacing, surgical LV epicardial lead, endocardial LV lead, or conduction system pacing. He ultimately chose endocardial LV lead placement due to the patient's dependence on lifelong anticoagulation and the poor response rate in patients who don't receive cardiac resynchronization therapy (CRT) after BiV ICD removal. He acknowledged the challenges of placing endocardial LV leads and the need for careful patient selection. The overall response rate in the AllSync trial for patients who received the endocardial LV lead was approximately 50%.

Meta Tag

Lecture ID 3922

Location Room 151

Presenter Charles A. Henrikson, MD, FHRS

Role Invited Speaker

Session Date and Time May 09, 2019 10:30 AM - 12:00 PM

Session Number S-011

Keywords

endocardial LV lead

cardiac resynchronization therapy

ICD

patient selection

response rate

generator erosion