Trans-coronary sinus intraseptal para-Hisian pacing: Cerclage pacing

Abstract

Introduction Physiologic pacing close to the His bundle is theoretically more ideal than right ventricular apical pacing. Moreover, several recent studies have shown that His-bundle pacing can normalize the QRS complex of left bundle branch blocks and has comparable clinical outcomes to those of biventricular pacing. However, in His or para-Hisian pacing, the issue of optimal lead positioning and maintenance are still recognized as technically challenging limitations for most clinicians Mitral cerclage annuloplasty, a method of catheter-based mitral valve repair, was introduced as a technology in which catheters or wires are delivered into the basal interventricular septal wall via the coronary sinus (CS) and septal vein. If this technology were applied to position the pacemaker lead into the septum, it would stabilize lead positioning. Here, we report the first human case of trans-coronary sinus intraseptal pacing (cerclage pacing) with a corresponding preclinical experiment.