RT Journal Article
SR Electronic
T1 Bilateral Venous Access for Cardiac Resynchronization Therapy in a Hemodialysis Patient With Cabozantinib-associated Heart Failure
JF In Vivo
JO In Vivo
FD International Institute of Anticancer Research
SP 1719
OP 1723
DO 10.21873/invivo.13973
VO 39
IS 3
A1 OTOI, AMANE
A1 HIGAKI, AKINORI
A1 MIURA, NORIYOSHI
A1 KUROKAWA, KEISHO
A1 YOSHIMOTO, KOHEI
A1 NISHIKAWA, TOMOAKI
A1 HORIE, RIKAKO
A1 ABE, ARISA
A1 NAKAO, YASUHISA
A1 FUJISAWA, TOMOKI
A1 MIYAZAKI, SHIGEHIRO
A1 AKAZAWA, YUSUKE
A1 MIYOSHI, TORU
A1 KAWAKAMI, HIROSHI
A1 HIGASHI, HARUHIKO
A1 TAMAKI, SHUNSUKE
A1 NISHIMURA, KAZUHISA
A1 INOUE, KATSUJI
A1 IKEDA, SHUNTARO
A1 YAMAGUCHI, OSAMU
YR 2025
UL http://iv.iiarjournals.org/content/39/3/1719.abstract
AB Background: Cabozantinib, a multi-targeted tyrosine kinase inhibitor, is widely used for the treatment of renal and hepatic cancers. While cabozantinib-associated cardiotoxicity is rare, it has been documented in several cases. In most instances, cancer therapeutics-related cardiac dysfunction (CTRCD) is managed by discontinuing cabozantinib and initiating cardioprotective agents. In this report, we present the case of a 63-year-old male with cabozantinib-induced heart failure (HF) with reduced ejection fraction (EF) and complete left bundle branch block (CLBBB).Case Report: The patient, undergoing hemodialysis for chronic kidney disease, had limited therapeutic options due to prior treatment failures. Despite six months of standard HF therapy, symptoms persisted, prompting cardiac resynchronization therapy (CRT) implantation without interrupting cabozantinib. Due to the presence of a dialysis shunt in the patient’s left arm, the right subclavian vein was selected for venous access to minimize the risk of lead-related complications. Using a tunneling tool, the left ventricular lead was placed via the contralateral vasculature to the ipsilateral generator. Six months post-CRT, echocardiography showed significant reverse remodeling with improved EF and reduced left ventricular end-diastolic diameter, alongside clinical symptom relief.Conclusion: This case highlights the utility of bilateral venous access with a tunneling tool in cardiac resynchronization therapy, particularly for patients with hemodialysis shunts.