Djuric, Predrag (52163459400)Predrag (52163459400)DjuricMladenovic, Zorica (57219652992)Zorica (57219652992)MladenovicDrobnjak, Dragan (56461183100)Dragan (56461183100)DrobnjakSpasic, Marijan (56157463900)Marijan (56157463900)SpasicJovic, Zoran (35366610200)Zoran (35366610200)JovicDjuric, Ivica (55676578600)Ivica (55676578600)DjuricBogdanovic, Predrag (56461299200)Predrag (56461299200)BogdanovicRomanovic, Radoslav (6602427698)Radoslav (6602427698)RomanovicMilašinovic, Goran (9238319300)Goran (9238319300)Milašinovic2025-06-122025-06-122021https://doi.org/10.2298/VSP200508061Dhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85121644980&doi=10.2298%2fVSP200508061D&partnerID=40&md5=d21d22cc1788fa065ac345c06f89691bhttps://remedy.med.bg.ac.rs/handle/123456789/4407Introduction. Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for "non-response" to CRT pacemaker could be the fail-ure to achieve optimal left ventricular (LV) lead position due to severe curve or stenosis/occlusion of the target vein. Case report. We presented a 79-old-male patient, New York Heart Association (NYHA) class III, with atrial fibrillation, chronic coronary syndrome (CCS), and prior myocardial infarction. The patient underwent coro-nary artery bypass surgery and mechanical prosthetic aor-tic valve implantation. He was indicated for CRT. The patient's venogram revealed ostial/proximal severe curve and stenosis of the posterolateral vein, the only vein of coronary sinus that led to anatomically optimal LV seg-ment for stimulation. After the balloon angioplasty of the curved and stenotic portion of the target vein with compliant balloon 4.0 × 30 mm, a satisfactory and stable position of quadripolar LV lead was achieved. Conclu-sion. Compliant balloon angioplasty could be a safe and efficient way to override severe coronary vein stenosis in some CRT cases. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.Angioplasty, balloonCardiac resynchronization therapyCoronary sinusHeart failure