PMID- 35169680 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220501 IS - 2514-2119 (Electronic) IS - 2514-2119 (Linking) VI - 6 IP - 2 DP - 2022 Feb TI - A case report of balloon-assisted tracking to overcome coronary sinus competent valve: a novel technique in left ventricular lead implantation. PG - ytac056 LID - 10.1093/ehjcr/ytac056 [doi] LID - ytac056 AB - BACKGROUND: Competent lateral and posterolateral valves showed proximal tortuosity that might hinder left ventricular (LV) lead implantation in cardiac resynchronization therapy (CRT). CASE SUMMARY: A 57-year-old woman was diagnosed as non-ischaemic cardiomyopathy, no other comorbidities, complaining of dyspnoea [New York Heart Association (NYHA) class III], and on optimal medical therapy. Electrocardiogram showed left bundle branch block with QRS duration 150 ms. The patient was candidate for CRT. However, during LV lead implantation, a competent posterolateral vein valve and proximal tortuosity hindered LV lead implantation that was overcome by balloon-assisted tracking technique. At 9 months of follow-up, the patient had NYHA class II, ejection fraction improved to 38%, and all implanted leads were still in place. DISCUSSION: Balloon-assisted tracking technique can be used to cross coronary sinus and smaller veins with competent valves and coronary veins tortuosity. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Samy, Mohamed AU - Samy M AUID- ORCID: 0000-0002-0478-7467 AD - Cardiology Department, Al-Azhar University, Mokhaim Al-Daemstreet, Mokhaim Al-Daem street, Nasr City, Cairo5, Egypt. FAU - Hamdy, Rehab M AU - Hamdy RM AD - Cardiology Department, Faculty of Medicine (For Girls), Al-Azhar University, Cairo, Egypt. LA - eng PT - Case Reports DEP - 20220202 PL - England TA - Eur Heart J Case Rep JT - European heart journal. Case reports JID - 101730741 PMC - PMC8841238 OTO - NOTNLM OT - Balloon-assisted tracking OT - Cardiac resynchronization therapy OT - Case report OT - Coronary sinus valves OT - Dilated cardiomyopathy EDAT- 2022/02/17 06:00 MHDA- 2022/02/17 06:01 PMCR- 2022/02/02 CRDT- 2022/02/16 05:49 PHST- 2021/07/22 00:00 [received] PHST- 2021/09/28 00:00 [revised] PHST- 2022/01/27 00:00 [accepted] PHST- 2022/02/16 05:49 [entrez] PHST- 2022/02/17 06:00 [pubmed] PHST- 2022/02/17 06:01 [medline] PHST- 2022/02/02 00:00 [pmc-release] AID - ytac056 [pii] AID - 10.1093/ehjcr/ytac056 [doi] PST - epublish SO - Eur Heart J Case Rep. 2022 Feb 2;6(2):ytac056. doi: 10.1093/ehjcr/ytac056. eCollection 2022 Feb.