Hemodynamics and prognosis after primary cardiac resynchronization system implantation compared to "upgrade" procedures.

Introduction: Left bundle brunch block (LBBB) and right ventricular stimulation (RVS) may be associated with asynchrony and heart failure. Differences between these two entities and their response to cardiac resynchronization therapy (CRT) are not well defined.

Methods: Patients receiving CRT from 1999 to 2006 were analyzed for cardiac events and prognosis separated between primary implants for LBBB (n = 221) and upgrades from RVS (n = 107).

Coronary sinus lead fragmentation 2 years after implantation with a retained guidewire.

Cardiac Resynchronization therapy (CRT) using coronary sinus (CS) leads is an established method for the therapy of congestive heart failure (CHF) in the case of inter- and intraventricular conduction delays. However implantation of CS leads is somewhat challenging due to a high number of peri- or postoperative dislocations at a rate of about 10%. The retained guidewire technique has been proposed for the implantation of coronary sinus leads for stabilization in case of repetitive intraoperative dislocations.