CRT Upgrade Procedures
Eight patients successfully underwent CRT upgrade procedures guided by
an Inner-Cath alone without any complications. Of all 8 patients
receiving CRT upgrade, 5 patients (62.5%) showed stenosis of the
subclavian vein (4 patients) or both subclavian and brachiocephalic
veins (1 patient) due to adhesions of pacemaker leads to the venous
wall. Consequently, one of the 5 patients only required a dilation of
the left subclavian vein for insertion of a 7Fr sheath into the stenotic
vein. In another patient with left subclavian and brachiocephalic vein
occlusions, a 7Fr sheath was successfully inserted through the occluded
veins with angioplasty (Figure 4).