ABSTRACT
Implantation of a biventricular pacing device requires proper knowledge of the target veins for implantation of the left ventricular lead, and awareness of potential difficulties that may be encountered. In this chapter, the anatomy of the coronary sinus and the tributaries of the coronary venous system, as well as their variations, are discussed. First, a description of the embryonic development of the coronary veins draining the heart is provided. Thereafter, attention will focus on the adult anatomy, and on the consequences of variations in anatomy for clinical practice in relation to the implantation of devices for cardiac resynchronization therapy (CRT). These difficulties will be illustrated by several case examples.
