Abstract
BACKGROUND: Cardiac resynchronization therapy (CRT) is an accepted device treatment in stable heart failure (HF) patients. In recent years increased awareness of coronary anatomy and implantation techniques have significantly impacted this evolving therapy. CASE PRESENTATION: In this article, we present a case describing the usefulness of the proximal balloon anchoring technique to enable initial coronary sinus (CS) cannulization and left ventricular (LV) lead placement in the tortuous coronary sinus during CRT implantation. CONCLUSIONS: The proximal anchor balloon technique can easily enable coronary sinus cannulization and left ventricular lead placement in patients with complex venous anatomy.