Reply to the Editor— The Jurdham Procedure: Endocardial Left Ventricular Lead Insertion via a Femoral Transseptal Sheath for Cardiac Resynchronization Therapy Pectoral Device Implantation

Abstract

We appreciate the comments made by Dr Gonna, Dr Dhillon, and Dr Gallagher, outlining additional approaches to achieving cardiac resynchronization therapy in patients who have either not responded to or have suboptimal targets for traditional left ventricular (LV) lead implant techniques. Our article is not intended to compare techniques or describe a novel approach to achieving cardiac resynchronization therapy, but rather to highlight a specific technique for endocardial LV lead implantation by using a set of readily available tools. Furthermore, we provide additional support for the safety and utility of endocardial LV lead implantation. We believe that as the interest in transseptal endocardial LV lead implantation continues to grow, specialized tools and techniques will be refined in a fashion similar to what has occurred with the traditional coronary venous approach. We appreciate the comments made by Dr Gonna, Dr Dhillon, and Dr Gallagher, outlining additional approaches to achieving cardiac resynchronization therapy in patients who have either not responded to or have suboptimal targets for traditional left ventricular (LV) lead implant techniques. Our article is not intended to compare techniques or describe a novel approach to achieving cardiac resynchronization therapy, but rather to highlight a specific technique for endocardial LV lead implantation by using a set of readily available tools. Furthermore, we provide additional support for the safety and utility of endocardial LV lead implantation. We believe that as the interest in transseptal endocardial LV lead implantation continues to grow, specialized tools and techniques will be refined in a fashion similar to what has occurred with the traditional coronary venous approach. To the Editor— The Jurdham procedure: Endocardial left ventricular lead insertion via a femoral transseptal sheath for cardiac resynchronization therapy pectoral device implantationHeart RhythmVol. 10Issue 1PreviewIn 2010, Dhillon and Gallagher1 described the femoral implantation and subclavian pull-through method for achieving cardiac resynchronization therapy in patients whose coronary venous system cannot be cannulated from a subclavian approach. Femoral access (14 F, not 20 F as Elencwaig et al2 suggest) is used to place a deployable lead in a cardiac vein. Van Gelder et al3 modified this method to implant a lead transseptally from a femoral approach, pulling through to a subclavian site in the same way. Full-Text PDF