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Figure 11 Use of MDCT in LV Lead Implantation
(A) A 3-dimensional volume-rendered reconstruction demonstrates the left pericardiophrenic bundle (LPCB), representing the left phrenic nerve. The course of the LPCB is indicated by white and yellow arrows. (B) The same view as in (A), after adjustment of the window level. The course of the LPCB is again represented by yellow arrows. In this reconstruction, the GCV and the lateral marginal branch (white arrow) are well visualized. Consequently, the relationship between the phrenic nerve and the cardiac veins can be well appreciated. (C) An occlusive venogram of the coronary sinus. The tortuous lateral marginal branch (white arrow) is clearly visualized. A good correlation with the noninvasive evaluation by MDCT (B) is seen. This vein was chosen as the target branch because it was not seen to intersect the course of the LPCB. (D) A unipolar lead placed in the target vein (white arrows). High-output pacing from the lead during the procedure did not reveal any diaphragmatic capture. Abbreviations as in Figures 3 and 5.
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