Cardiac vein angioplasty for biventricular pacing

Biventricular pacing for the treatment of congestive heart failure has consistently demonstrated improvement in quality-of-life and reduction in heart failure symptoms. Though the over-the-wire systems will be helpful in overcoming many existing obstacles to optimal lead placement, anatomic variability will still limit overall success. Cardiac vein angioplasty may be required for deployment of leads into tortuous or obstructed cardiac veins. This case report describes the angioplasty of a focal cardiac vein stenosis allowing for successful implantation of a left ventricular pacing lead. The safety of this procedure is unknown, though the risks may be acceptable in certain patients.