Turk Kardiyol Dern Ars. 2026; 54(4): 352-356 | DOI: 10.5543/tkda.2025.53506
Left Bundle Branch-Optimized Cardiac Resynchronization Therapy in a Patient with a Carillon Annuloplasty Device: Challenges and Solutions
Hasan Kan1, Ahmet Taha Şahin2, Ahmet Lütfü Sertdemir1, Enes Elvin Gül11Department of Cardiology, Necmettin Erbakan University, School of Medicine, Konya, Turkiye
2Department of Cardiology, Beyhekim Training and Research Hospital, Konya, Turkiye
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure, but prior interventions like percutaneous mitral annuloplasty may hinder lead placement. We present a 70-year-old male with ischemic cardiomyopathy and severe functional mitral regurgitation who previously received a Carillon device. Due to coronary sinus inaccessibility, left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) was performed. The procedure was successful, with improved QRS duration, echocardiographic findings, and clinical status. This case highlights LOT-CRT as a viable alternative in patients with challenging anatomy, offering physiological pacing when conventional CRT is not feasible.
Keywords: Carillon mitral contour system, conduction system pacing, left bundle branch-optimized cardiac resynchronization therapy
Corresponding Author: Ahmet Taha Şahin
Manuscript Language: English