Snare technique for coronary sinus cannulation in cardiac resynchronization therapy

PurposeBiventricular pacing is a mainstay of therapy for patients with heart failure. However, lead implantations may fail due to anatomical reasons including the impossibility of coronary sinus cannulation.Methods and resultsA dual approach from the subclavian vein using a snare through a sheath and from the femoral vein using a steerable electrophysiology catheter was performed. Once the snare hooked the catheter, the latter was advanced into the coronary sinus and finally, the sheath could also be advanced in an “over-the-wire” technique.ConclusionThe snare technique for coronary sinus cannulation offers a “bail-out” strategy for left ventricular lead implantation.