Long-Term Follow-Up of Isolated Epicardial Left Ventricular Lead Implant Using a Minithoracotomy Approach for Cardiac Resynchronization Therapy

Background Transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy is unsuccessful in 5–10% of reported cases. These patients may benefit from isolated surgical placement of an epicardial LV lead via minithoracotomy approach. Aim To evaluate the success of this approach at long‐term follow‐up. Methods Retrospective evaluation of all consecutive patients undergoing isolated epicardial LV lead placement after failed transvenous attempt over a 6‐year period. Data collected on baseline parameters, procedural details, and outcome at follow‐up (hospital stay, complications, mortality, and clinical response). Results Forty‐two patients underwent epicardial lead implant. Five died within 1 year (11.9%): two (4.8%) died within 30‐days post op (one from intraoperative hemorrhage, the other from multiple organ failure); 39 (95.1%) were admitted to the high dependency unit and transferred to the ward