Implant Topics
- How to Cross a Subclavian Obstruction
- How to Perform a Subclavian Fibroplasty Once a Wire is Across
- Venoplasty & Lead Removal: An Alternative to Extraction
- Systematic Approach to Basic CS Cannulation
- Difficult to Locate CS: Levophase; CS venography
- Difficult to Cannulate CS: Vein Selector, Anchor Balloon & Jumbo
- Unstable CS Access: Support Wire & Jumbo Sheath
- CS Anomalies: CS Atresia, Patent Vein of Marshall, Atretic CS with dominant PL/MCV & PVOM
- How to Safely Perform CS Venography; You can’t Implant if you don’t See the Targets (Occlusive & Selective)
- Amplatz Support Wire Technique
- Using Vein Selectors to Make Difficult Cases Easier
- Microcatheter: How to use for Difficult LV lead Implantation
- Snare Technique – Orthodromic
- Snare Technique – Antidromic
- Snare Technique: Other Uses
- Venoplasty: Coronary Sinus & Branch Veins
- How to Fix High DFTs
- Extraction: Powered & Femoral Sheaths
- Right Sided Implants
- Iliac Vein Implantation
- Conduction System Pacing: HIS & LB
- Electrical AV Optimization at the Time of Implant
- RESPICARDIA Device Implantation
- How to Deal with CS cannulation when Vieussens Valve Directs your Wire into the Vein of Marshall – Recent Case Example (Feb 2020)
Welcome to BIVTIPS
By combining process optimization & applying interventional tools/techniques the results of LV lead implantation, compared to the traditional approach are improved significantly:
- Implant time are reduced.
- Lead position is improved.
- Epicardial LV leads nearly eliminated.
Some say that adopting the interventional approach makes LV lead implantation “fun” because it provides a series of options for difficult cases.
This website is intended to provide an educational resource for EP physicians interested in learning the “Interventional Approach to Device Implantation.” The material contained in this website reflects my experience over the last 20 years both in my own lab as well as proctoring physicians in their labs around the world. Most of the advances of “Interventional Device Implantation” derived from encouragement, suggestions & comments by the lab staff, vendor support personal & other physicians. The fellows are a constant source of new ideas on how to improve the process. I try to learn something new every day, thus the website is a work in process.
With regard to conflict of interest, all of the products I recommend are those that I find work best regardless of manufacturer. I receive compensation from Merit Medical & Pressure Products for the tools I developed that were necessary to implement the process.
About Seth Worley, MD:
I am a graduate of the Temple University School of Medicine and completed my internship and residency in internal medicine at Strong Memorial Hospital in Rochester, NY. After completing a fellowship in cardiology and electrophysiology at Duke University Medical Center, I became the co-director of the Coronary Care Unit and Assistant Professor of Medicine. From Duke, I was recruited to the Mayo Clinic where I was Assistant Professor of Medicine in the Division of Cardiology prior to relocating to Lancaster for 30 years. In June of 2017, I became a senior consultant, in the Section of Cardiac Electrophysiology for the MedStar Heart & Vascular Institute, in Washington, D.C. The opinions expressed here should not be construed to reflect those of MedStar.
I am board certified in clinical cardiac electrophysiology, and a fellow of the Heart Rhythm Society.
Please offer comments & suggestions to improve the contained material directly to me seth@mcworley.com.
Please feel free to contact me with questions about difficult cases at seth@mcworley.com
Physicians interested in presenting cases to add to the material are encouraged. The case will be posted with your name under “Why didn’t I think of that”
Merit Medical provides educational programs for those interested.
