Endocardial left ventricular lead placement from the left subclavian vein approach

Aims In up to 10-15% of cases, the traditional epicardial approach for left ventricular (LV) lead placement is not feasible and surgical implantation is considered the alternative. We present the implantation of a transseptal LV lead through a left subclavian access. Methods and results Through the left subclavian vein access and using a system which includes a guiding catheter, a puncture screw catheter and a puncture stylet, access to the LV was achieved and the LV stimulation lead was successfully implanted. Conclusion We describe the implantation of a transseptal LV stimulation lead through a left subclavian access.