Successful implantation of cardiac resynchronization therapy in a patient with coronary sinus reducer using proximal coronary sinus branches: a case report

The CSR has shown promise in relieving refractory angina. As ischaemic heart disease progresses, CRT may become necessary in patients with CSR. The CSR's design can reduce the vascular lumen and complicate lead placement. Previous reports have confirmed the technical feasibility of CRT with CSR but lack long-term safety data. This case highlights that, under favourable anatomical conditions, proximal tributaries of the coronary sinus can be used for lead placement, potentially avoiding complications from reduced venous outflow.