Document Detail

Right ventricular septal pacing: a comparative study of outflow tract and mid ventricular sites.
MedLine Citation:
PMID:  20636311     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Prolonged right ventricle (RV) apical pacing is associated with left ventricle (LV) dysfunction due to dysynchronous ventricular activation and contraction. Alternative RV pacing sites with a narrower QRS compared to RV pacing might reflect a more physiological and synchronous LV activation. The purpose of this study was to compare the QRS morphology, duration, and suitability of RV outflow tract (RVOT) septal and mid-RV septal pacing.
METHODS: Seventeen consecutive patients with indication for dual-chamber pacing were enrolled in the study. Two standard 58-cm active fixation leads were passed to the RV and positioned in the RVOT septum and mid-RV septum using a commercially available septal stylet (model 4140, St. Jude Medical, St. Paul, MN, USA). QRS duration, morphology, and pacing parameters were compared at the two sites. The RV lead with less-satisfactory electrical parameters was withdrawn and deployed in the right atrium.
RESULTS: Successful positioning of the pacing leads at the RVOT septum and mid-RV septum was achieved in 15 patients (88.2%). There were no significant differences in the mean stimulation threshold, R-wave sensing, and lead impedance between the two sites. The QRS duration in the RVOT septum was 151 ± 14 ms and in the mid-RV septum 145 ± 13 ms (P = 0.150).
CONCLUSIONS: This prospective observational study shows that septal pacing can be reliably achieved both in the RVOT and mid-RV with active fixation leads using a specifically shaped stylet. There are no preferences in regard to acute lead performance or paced QRS duration with either position.
Raphael Rosso; Caroline Medi; Andrew W Teh; Thuy To Hung; Alexander Feldman; Geoffrey Lee; Harry G Mond
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1169-73     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Department of Cardiology, Royal Melbourne Hospital, Victoria 3050, Melbourne, Australia.
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MeSH Terms
Aged, 80 and over
Atrioventricular Block / physiopathology,  therapy*
Cardiac Pacing, Artificial*
Heart Ventricles / physiopathology*
Prospective Studies
Sick Sinus Syndrome / physiopathology,  therapy*
Treatment Outcome
Ventricular Septum / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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